High facility-level serum potassium variability associated with mortality in hemodialysis patients: results from Chinese Dialysis Outcomes and Practice Patterns Study (DOPPS)

The role of facility-level serum potassium (sK+) variability (FL-SPV) in dialysis patients has not been extensively studied. This study aimed to evaluate the association between FL-SPV and clinical outcomes in hemodialysis patients using data from the China Dialysis Outcomes and Practice Patterns St...

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Main Authors: Xinju Zhao, Fan Fan Hou, Xinling Liang, Zhaohui Ni, Xiaonong Chen, Yuqing Chen, Liangying Gan, Li Zuo
Format: Article
Language:English
Published: Taylor & Francis Group 2023-12-01
Series:Renal Failure
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Online Access:https://www.tandfonline.com/doi/10.1080/0886022X.2023.2211157
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author Xinju Zhao
Fan Fan Hou
Xinling Liang
Zhaohui Ni
Xiaonong Chen
Yuqing Chen
Liangying Gan
Li Zuo
author_facet Xinju Zhao
Fan Fan Hou
Xinling Liang
Zhaohui Ni
Xiaonong Chen
Yuqing Chen
Liangying Gan
Li Zuo
author_sort Xinju Zhao
collection DOAJ
description The role of facility-level serum potassium (sK+) variability (FL-SPV) in dialysis patients has not been extensively studied. This study aimed to evaluate the association between FL-SPV and clinical outcomes in hemodialysis patients using data from the China Dialysis Outcomes and Practice Patterns Study (DOPPS) 5. FL-SPV was defined as the standard deviation (SD) of baseline sK+ of all patients in each dialysis center. The mean and SD values of FL-SPV of all participants were calculated, and patients were divided into the high FL-SPV (>the mean value) and low FL-SPV (≤the mean value) groups. Totally, 1339 patients were included, with a mean FL-SPV of 0.800 mmol/L. Twenty-three centers with 656 patients were in the low FL-SPV group, and 22 centers with 683 patients were in the high FL-SPV group. Multivariate logistic regression analysis showed that liver cirrhosis (OR = 4.682, 95% CI: 1.246–17.593), baseline sK+ (<3.5 vs. 3.5 ≤ sK+ < 5.5 mmol/L, OR = 2.394, 95% CI: 1.095–5.234; ≥5.5 vs. 3.5 ≤ sK+ < 5.5 mmol/L, OR = 1.451, 95% CI: 1.087–1.939), dialysis <3 times/week (OR = 1.472, 95% CI: 1.073–2.020), facility patients’ number (OR = 1.088, 95% CI: 1.058–1.119), serum HCO3– level (OR = 0.952, 95% CI: 0.921–0.984), dialysis vintage (OR = 0.919, 95% CI: 0.888–0.950), other cardiovascular disease (OR = 0.508, 95% CI: 0.369–0.700), and using high-flux dialyzer (OR = 0.425, 95% CI: 0.250–0.724) were independently associated with high FL-SPV (all p < .05). After adjusting potential confounders, high FL-SPV was an independent risk factor for all-cause death (HR = 1.420, 95% CI: 1.044–1.933) and cardiovascular death (HR = 1.827, 95% CI: 1.188–2.810). Enhancing the management of sK+ of hemodialysis patients and reducing FL-SPV may improve patient survival.
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spelling doaj-art-9d7632b974cd4f13a515b75fa62310a12025-08-20T02:28:54ZengTaylor & Francis GroupRenal Failure0886-022X1525-60492023-12-0145110.1080/0886022X.2023.2211157High facility-level serum potassium variability associated with mortality in hemodialysis patients: results from Chinese Dialysis Outcomes and Practice Patterns Study (DOPPS)Xinju Zhao0Fan Fan Hou1Xinling Liang2Zhaohui Ni3Xiaonong Chen4Yuqing Chen5Liangying Gan6Li Zuo7Department of Nephrology, Peking University People’s Hospital, Beijing, ChinaDivision of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center of Kidney Disease, State Key Laboratory of Organ Failure Research, Guangzhou, ChinaDivision of Nephrology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangdong, ChinaRenal Division, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, ChinaDivision of Nephrology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, ChinaRenal Division, Peking University First Hospital, Beijing, ChinaDepartment of Nephrology, Peking University People’s Hospital, Beijing, ChinaDepartment of Nephrology, Peking University People’s Hospital, Beijing, ChinaThe role of facility-level serum potassium (sK+) variability (FL-SPV) in dialysis patients has not been extensively studied. This study aimed to evaluate the association between FL-SPV and clinical outcomes in hemodialysis patients using data from the China Dialysis Outcomes and Practice Patterns Study (DOPPS) 5. FL-SPV was defined as the standard deviation (SD) of baseline sK+ of all patients in each dialysis center. The mean and SD values of FL-SPV of all participants were calculated, and patients were divided into the high FL-SPV (>the mean value) and low FL-SPV (≤the mean value) groups. Totally, 1339 patients were included, with a mean FL-SPV of 0.800 mmol/L. Twenty-three centers with 656 patients were in the low FL-SPV group, and 22 centers with 683 patients were in the high FL-SPV group. Multivariate logistic regression analysis showed that liver cirrhosis (OR = 4.682, 95% CI: 1.246–17.593), baseline sK+ (<3.5 vs. 3.5 ≤ sK+ < 5.5 mmol/L, OR = 2.394, 95% CI: 1.095–5.234; ≥5.5 vs. 3.5 ≤ sK+ < 5.5 mmol/L, OR = 1.451, 95% CI: 1.087–1.939), dialysis <3 times/week (OR = 1.472, 95% CI: 1.073–2.020), facility patients’ number (OR = 1.088, 95% CI: 1.058–1.119), serum HCO3– level (OR = 0.952, 95% CI: 0.921–0.984), dialysis vintage (OR = 0.919, 95% CI: 0.888–0.950), other cardiovascular disease (OR = 0.508, 95% CI: 0.369–0.700), and using high-flux dialyzer (OR = 0.425, 95% CI: 0.250–0.724) were independently associated with high FL-SPV (all p < .05). After adjusting potential confounders, high FL-SPV was an independent risk factor for all-cause death (HR = 1.420, 95% CI: 1.044–1.933) and cardiovascular death (HR = 1.827, 95% CI: 1.188–2.810). Enhancing the management of sK+ of hemodialysis patients and reducing FL-SPV may improve patient survival.https://www.tandfonline.com/doi/10.1080/0886022X.2023.2211157Potassiummortalityhemodialysischronic kidney disease
spellingShingle Xinju Zhao
Fan Fan Hou
Xinling Liang
Zhaohui Ni
Xiaonong Chen
Yuqing Chen
Liangying Gan
Li Zuo
High facility-level serum potassium variability associated with mortality in hemodialysis patients: results from Chinese Dialysis Outcomes and Practice Patterns Study (DOPPS)
Renal Failure
Potassium
mortality
hemodialysis
chronic kidney disease
title High facility-level serum potassium variability associated with mortality in hemodialysis patients: results from Chinese Dialysis Outcomes and Practice Patterns Study (DOPPS)
title_full High facility-level serum potassium variability associated with mortality in hemodialysis patients: results from Chinese Dialysis Outcomes and Practice Patterns Study (DOPPS)
title_fullStr High facility-level serum potassium variability associated with mortality in hemodialysis patients: results from Chinese Dialysis Outcomes and Practice Patterns Study (DOPPS)
title_full_unstemmed High facility-level serum potassium variability associated with mortality in hemodialysis patients: results from Chinese Dialysis Outcomes and Practice Patterns Study (DOPPS)
title_short High facility-level serum potassium variability associated with mortality in hemodialysis patients: results from Chinese Dialysis Outcomes and Practice Patterns Study (DOPPS)
title_sort high facility level serum potassium variability associated with mortality in hemodialysis patients results from chinese dialysis outcomes and practice patterns study dopps
topic Potassium
mortality
hemodialysis
chronic kidney disease
url https://www.tandfonline.com/doi/10.1080/0886022X.2023.2211157
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