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During the congress, E-Posters will be accessible to all participants on the congress website 24/7, as well as in the E-poster stations in the congress center.
Preparing your E-Poster
Please review the E-Poster format requirements carefully when preparing your E-Poster. Should your E-Poster not meet the mentioned requirements, it may not be displayed as described above.
E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
Please follow the instructions below to input your abstract title.
Abstract titles should be brief and reflect the content of the abstract.
Hyperkalemia is a common complication in patients with chronic kidney disease (CKD) and is associated with mortality. The relationship between serum potassium and mortality reportedly follows a U-shaped curve, and guidelines recommend maintaining potassium levels between 4.5 and 5.5 mEq/L. However, the association between serum potassium and renal outcomes remains unclear. This study investigated the relationship between serum potassium concentration and renal prognosis using data from the J-CKD-DB-Ex.
Patients were classified into four groups according to baseline serum potassium (K) levels: ≤3.9 mEq/L (hypokalemia/low range), 4.0–<4.9 mEq/L (reference/optimal range), 5.0–<5.4 mEq/L (high-normal/mild hyperkalemia range), and ≥5.5 mEq/L (hyperkalemia range). The primary endpoint was the time to the first occurrence of a composite renal outcome, defined as end-stage kidney disease (ESKD; eGFR < 15 mL/min/1.73 m²) or a ≥30% decline in eGFR from the index date. A total of 19,853 CKD patients were analyzed. The distribution across potassium groups was: ≤3.9 mEq/L, 2,803 (14.1%); 4.0–<4.9 mEq/L, 14,937 (75.2%); 5.0–<5.4 mEq/L, 1,690 (8.5%); and ≥5.5 mEq/L, 423 (2.1%).
Higher potassium levels were associated with older age (≤3.9 mEq/L: 71.0 years; 4.0–<4.9 mEq/L: 72.0; 5.0–<5.4 mEq/L: 74.0; ≥5.5 mEq/L: 75.0) and lower eGFR (50.5, 50.1, 43.5, and 36.5 mL/min/1.73 m², respectively). Kaplan–Meier analysis demonstrated that higher potassium levels were significantly associated with a higher incidence of the composite renal endpoint (log-rank p < 0.0001). The cumulative incidence rates were 13%, 11%, 20%, and 30%, indicating a stepwise increase with rising potassium levels. Compared with the reference group (4.0–<4.9 mEq/L), all other potassium categories exhibited significantly poorer renal outcomes. In multivariable Cox models adjusted for age, sex, baseline eGFR, diabetes, hypertension, and the use of RAS and SGLT2 inhibitors, both low and high potassium levels were independently associated with adverse renal outcomes. Adjusted hazard ratios (HRs) were: ≤3.9 mEq/L, HR 1.22 (95% CI 1.09–1.37; p < 0.001); 5.0–<5.4 mEq/L, HR 1.47 (95% CI 1.31–1.65; p < 0.001); and ≥5.5 mEq/L, HR 1.91 (95% CI 1.59–2.29; p < 0.001).
Both hypokalemia and hyperkalemia were independently associated with increased risk of CKD progression. Dyskalemia may influence not only mortality but also renal outcomes. Prospective studies are needed to determine whether modifying serum potassium levels can improve renal prognosis in CKD patients.
