Blood potassium fluctuations before and after dialysis in maintenance hemodialysis patients

doi:10.3969/j.issn.1004-583X.2024.09.005

Abstract

Abstract:

Objective To observe the fluctuations of serum potassium in maintenance hemodialysis (MHD) patients before and after hemodialysis.Methods A total of 42 MHD patients admitted in the Nephrology and Rheumatology Department of Zunyi Hospital of Traditional Chinese Medicine from February 2021 to February 2023 were selected. According to the median grouping method, patients were divided into Δserum potassium (difference of serum potassium before and after dialysis) ≥1.44 mmol/L group (n=21) and Δserum potassium <1.44 mmol/L group (n=21). Clinical data between the two groups were compared. Results There were no significant differences in the age, gender, urea reduction ratio (URR), single-pool urea Kt/V (sp Kt/V) and hemodialysis (HD) mode between the two groups (P>0.05). Compared with the Δserum potassium <1.44 mmol/L group, the proportion of non-diabetic nephropathy (P =0.019) and serum potassium before dialysis were significantly higher in the Δserum potassium ≥1.44 mmol/L group (P <0.001). Partial correlation analysis showed that after adjusting for age, Δserum potassium was positively correlated with serum potassium before and after dialysis, and the positive correlation between Δserum potassium and serum potassium before dialysis was more significant (P <0.05).Conclusion Non-diabetic nephropathy as the comorbidity and the high-level serum potassium before MHD is related to the large fluctuation of serum potassium before and after MHD, which should be paid attention to in clinical practice.

Key words: maintenance hemodialysis, blood potassium fluctuations, influencing factor

CLC Number:

R459.5

Yang Haiyan, Chen Ling, Dai Bo, Liu Xia, Sun Shangping. Blood potassium fluctuations before and after dialysis in maintenance hemodialysis patients[J]. Clinical Focus, 2024, 39(9): 798-802.

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URL: https://huicui.hebmu.edu.cn/EN/10.3969/j.issn.1004-583X.2024.09.005

https://huicui.hebmu.edu.cn/EN/Y2024/V39/I9/798

Figures/Tables 3

Tab.1 Basic characteristics between the two groups

组别	例数	年龄 (岁)	基础病[例(%)]		性别[例(%)]		HD模式[例(%)]
组别	例数	年龄 (岁)	非糖尿病肾病	糖尿病肾病	男性	女性	HD	HDF	HD+HP
Δ血钾≥1.44 mmol/L组	21	56.19±12.75	18(85.7)	3(14.3)	9(42.8)	12(57.2)	11(52.4)	4(19.0)	6(28.6)
Δ血钾<1.44 mmol/L组	21	62.95±13.68	11(52.4)	10(47.6)	9(42.8)	12(57.2)	15(71.4)	4(19.0)	2(9.6)
统计值		$t$ =1.657	χ²=5.459		χ²=0.857		χ²=2.711
P值		0.105	0.019		0.355		0.258

Tab.1 Basic characteristics between the two groups

组别	例数	年龄 (岁)	基础病[例(%)]		性别[例(%)]		HD模式[例(%)]
组别	例数	年龄 (岁)	非糖尿病肾病	糖尿病肾病	男性	女性	HD	HDF	HD+HP
Δ血钾≥1.44 mmol/L组	21	56.19±12.75	18(85.7)	3(14.3)	9(42.8)	12(57.2)	11(52.4)	4(19.0)	6(28.6)
Δ血钾<1.44 mmol/L组	21	62.95±13.68	11(52.4)	10(47.6)	9(42.8)	12(57.2)	15(71.4)	4(19.0)	2(9.6)
统计值		$t$ =1.657	χ²=5.459		χ²=0.857		χ²=2.711
P值		0.105	0.019		0.355		0.258

Tab.2 Laboratory data between the two groups

组别	例数	HD前血钾 (mmol/L)	HD后血钾 (mmol/L)	Δ血钾	URR (%)	sp Kt/V
Δ血钾≥1.44 mmol/L组	21	5.40±0.64	3.25±0.26	2.15±0.51	71.39(69.69, 78.58)	1.49(1.40, 1.84)
Δ血钾<1.44 mmol/L组	21	4.02±0.36	2.93±0.29	1.09±0.21	71.14(69.28, 73.31)	1.44(1.37, 1.52)
统计值		$t$ =-8.619	$t$ =-3.839	$t$ =-8.715	$Z$ =0.616	$Z$ =1.158
P值		<0.001	<0.001	<0.001	0.538	0.247

Tab.2 Laboratory data between the two groups

组别	例数	HD前血钾 (mmol/L)	HD后血钾 (mmol/L)	Δ血钾	URR (%)	sp Kt/V
Δ血钾≥1.44 mmol/L组	21	5.40±0.64	3.25±0.26	2.15±0.51	71.39(69.69, 78.58)	1.49(1.40, 1.84)
Δ血钾<1.44 mmol/L组	21	4.02±0.36	2.93±0.29	1.09±0.21	71.14(69.28, 73.31)	1.44(1.37, 1.52)
统计值		$t$ =-8.619	$t$ =-3.839	$t$ =-8.715	$Z$ =0.616	$Z$ =1.158
P值		<0.001	<0.001	<0.001	0.538	0.247

Tab.3 Partial correlation analysis of Δ serum potassium and HD related indicators

指标	未校正		校正后
指标	$r$ 值	P值	$r'$ 值	P值
HD前血钾	0.950	<0.001	0.949	<0.001
sp Kt/V	0.306	0.049	0.270	0.088
URR	0.174	0.270	0.165	0.303
HD后血钾	0.515	<0.001	0.445	0.004
年龄	-0.299	0.054	-	-

Tab.3 Partial correlation analysis of Δ serum potassium and HD related indicators

指标	未校正		校正后
指标	$r$ 值	P值	$r'$ 值	P值
HD前血钾	0.950	<0.001	0.949	<0.001
sp Kt/V	0.306	0.049	0.270	0.088
URR	0.174	0.270	0.165	0.303
HD后血钾	0.515	<0.001	0.445	0.004
年龄	-0.299	0.054	-	-

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