Effect of oral potassium supplementation on urinary potassium excretion and its diagnostic value for primary aldosteronism
Objectives We aimed to: (1) explore the effect of oral potassium supplementation on urinary potassium excretion, and (2) evaluate the value of urinary potassium-related indicators in distinguishing primary aldosteronism (PA) from non-PA patients.Design and methods A prospective study of 20 patients...
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Taylor & Francis Group
2025-12-01
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| Series: | Clinical and Experimental Hypertension |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/10641963.2025.2457768 |
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| author | Ke Zhang Xiyun Deng Zhuoran Li Chen Yi Jianqiong Kong Yunhong Wang |
| author_facet | Ke Zhang Xiyun Deng Zhuoran Li Chen Yi Jianqiong Kong Yunhong Wang |
| author_sort | Ke Zhang |
| collection | DOAJ |
| description | Objectives We aimed to: (1) explore the effect of oral potassium supplementation on urinary potassium excretion, and (2) evaluate the value of urinary potassium-related indicators in distinguishing primary aldosteronism (PA) from non-PA patients.Design and methods A prospective study of 20 patients with hypertension and hypokalemia caused by renal potassium loss between November 2023 and April 2024 was conducted. Demographic features, 24-hour urine collection before and after potassium supplementation were all collected.Results The patients had a mean age of 49.38 years and 70% were male. Following a median potassium supplement dose of 8.50 g, serum potassium increased from 3.25 to 3.90 mmol/L (p < .001), and 24-hour urinary potassium (24 h UK) rose from 41.40 to 59.75 mmol/24 h (p = .004). After supplementation, 20% of patients had decreased 24 h UK, while 25%, 25%, and 40% showed increases of 0–10, 10–20, and > 20 mmol/24 h. Urinary-to-serum potassium ratio (USR) decreased in 40% of patients, while it increased by 0–5, 5–10, and > 10 L/24 h in 25%, 25%, and 10% of patients, respectively. Both 24 h UK and USR after repletion predicted PA with moderate-to-high accuracy (AUC = 0.808 for both). The optimal cutoff of 24 h UK and USR after supplementation were 51 mmol/24 h and 17.43 L/24 h. The AUC for 24 h USR and 24 h UK before repletion in predicting PA were 0.788 and 0.652, respectively.Conclusions Urinary potassium does not increase proportionally with serum potassium levels or the oral potassium dose, showing individual variability. Post-supplementation urinary potassium has greater diagnostic value for distinguishing PA than pre-supplementation indicators. |
| format | Article |
| id | doaj-art-3da4d06a3bf44c1096e53061b5e0d149 |
| institution | Kabale University |
| issn | 1064-1963 1525-6006 |
| language | English |
| publishDate | 2025-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Clinical and Experimental Hypertension |
| spelling | doaj-art-3da4d06a3bf44c1096e53061b5e0d1492025-01-23T13:21:36ZengTaylor & Francis GroupClinical and Experimental Hypertension1064-19631525-60062025-12-0147110.1080/10641963.2025.2457768Effect of oral potassium supplementation on urinary potassium excretion and its diagnostic value for primary aldosteronismKe Zhang0Xiyun Deng1Zhuoran Li2Chen Yi3Jianqiong Kong4Yunhong Wang5Department of Vascular Surgery, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaFuwai Hospital, Chinese Academy of Medical Sciences, Shenzhen, ChinaFuwai Hospital, Chinese Academy of Medical Sciences, Shenzhen, ChinaFuwai Hospital, Chinese Academy of Medical Sciences, Shenzhen, ChinaFuwai Hospital, Chinese Academy of Medical Sciences, Shenzhen, ChinaDepartment of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, ChinaObjectives We aimed to: (1) explore the effect of oral potassium supplementation on urinary potassium excretion, and (2) evaluate the value of urinary potassium-related indicators in distinguishing primary aldosteronism (PA) from non-PA patients.Design and methods A prospective study of 20 patients with hypertension and hypokalemia caused by renal potassium loss between November 2023 and April 2024 was conducted. Demographic features, 24-hour urine collection before and after potassium supplementation were all collected.Results The patients had a mean age of 49.38 years and 70% were male. Following a median potassium supplement dose of 8.50 g, serum potassium increased from 3.25 to 3.90 mmol/L (p < .001), and 24-hour urinary potassium (24 h UK) rose from 41.40 to 59.75 mmol/24 h (p = .004). After supplementation, 20% of patients had decreased 24 h UK, while 25%, 25%, and 40% showed increases of 0–10, 10–20, and > 20 mmol/24 h. Urinary-to-serum potassium ratio (USR) decreased in 40% of patients, while it increased by 0–5, 5–10, and > 10 L/24 h in 25%, 25%, and 10% of patients, respectively. Both 24 h UK and USR after repletion predicted PA with moderate-to-high accuracy (AUC = 0.808 for both). The optimal cutoff of 24 h UK and USR after supplementation were 51 mmol/24 h and 17.43 L/24 h. The AUC for 24 h USR and 24 h UK before repletion in predicting PA were 0.788 and 0.652, respectively.Conclusions Urinary potassium does not increase proportionally with serum potassium levels or the oral potassium dose, showing individual variability. Post-supplementation urinary potassium has greater diagnostic value for distinguishing PA than pre-supplementation indicators.https://www.tandfonline.com/doi/10.1080/10641963.2025.2457768Hypokalemiarenal potassium lossprimary aldosteronismurinary potassium excretion |
| spellingShingle | Ke Zhang Xiyun Deng Zhuoran Li Chen Yi Jianqiong Kong Yunhong Wang Effect of oral potassium supplementation on urinary potassium excretion and its diagnostic value for primary aldosteronism Clinical and Experimental Hypertension Hypokalemia renal potassium loss primary aldosteronism urinary potassium excretion |
| title | Effect of oral potassium supplementation on urinary potassium excretion and its diagnostic value for primary aldosteronism |
| title_full | Effect of oral potassium supplementation on urinary potassium excretion and its diagnostic value for primary aldosteronism |
| title_fullStr | Effect of oral potassium supplementation on urinary potassium excretion and its diagnostic value for primary aldosteronism |
| title_full_unstemmed | Effect of oral potassium supplementation on urinary potassium excretion and its diagnostic value for primary aldosteronism |
| title_short | Effect of oral potassium supplementation on urinary potassium excretion and its diagnostic value for primary aldosteronism |
| title_sort | effect of oral potassium supplementation on urinary potassium excretion and its diagnostic value for primary aldosteronism |
| topic | Hypokalemia renal potassium loss primary aldosteronism urinary potassium excretion |
| url | https://www.tandfonline.com/doi/10.1080/10641963.2025.2457768 |
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