Serum potassium level in maintenance hemodialysis patients and its effect on outcome

doi:10.3969/j.issn.1674-8115.2023.04.015

Abstract

Abstract:

Maintenance hemodialysis is one of the renal replacement therapy that end-stage renal disease patients mainly rely on. Dyskalemia is one of the most common metabolic complications in patients undergoing maintenance hemodialysis. Both pre-dialysis hyperkalemia and hypokalemia during and after dialysis may contribute to a higher risk of all-cause mortality, cardiovascular mortality in hemodialysis patients. The impact of serum potassium fluctuation has attracted widespread attention in recent years. Due to the intermittent nature of maintenance hemodialysis, patients are prone to frequent fluctuations of serum potassium. Potassium variability may be a better indicator to reflect potassium homeostasis, and large variability of potassiun is recognized as a potential risk factor for poor outcomes. In addition, the rapid fluctuation of serum potassium concentration during hemodialysis may increase the risk of malignant arrhythmia, sudden cardiac death and other poor outcomes. The gradient of serum and dialysate potassium is an important factor that influence the removal of potassium, which is also affected by other dialysate components. Therefore, strengthening the monitoring and management of serum potassium, selecting appropriate dialysate potassium concentration and individualizing dialysate prescription may be beneficial to maintain potassium homeostasis, reduce dyskalemia and improve prognosis. This review briefly expounds the feature of serum potassium level and discusses its effect on outcomes in patients with maintenance hemodialysis, emphasizing the relevance of potassium variation and prognosis in patients with maintenance hemodialysis and the impact of dialysate composition on potassium homeostasis.

Key words: maintenance hemodialysis, potassium, variability, dialysate potassium, prognosis

CLC Number:

R459.5

MEN Ru, ZHU Minxia, ZHANG Weiming. Serum potassium level in maintenance hemodialysis patients and its effect on outcome[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2023, 43(4): 507-513.

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