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Association between hypokalemia, malnutrition and mortality in peritoneal dialysis patients

INTRODUCTION: Hypokalemia is found in peritoneal dialysis (PD) patients. The problem may be severe and promote mortality. Several factors may trigger the hypokalemia in PD patients, such as preexisting malnutrition and the low protein and potassium food intake. OBJECTIVES: To verify the prevalence of hypokalemia and its association with mortality, nutrition status, clinical, laboratory and electrocardiographic variables in PD patients. METHODS: Serum K+ levels were evaluated retrospectively in PD patients. Hypokalemia was defined when the average of serum K+ was < 3.5 mEq/L in six consecutive measurements. Other available biochemical tests were also evaluated. Subjective Global Assessment (SGA) and body mass index (BMI) were used to assess the nutrition status. A questionnaire was applied to identify the most common symptoms and signals associated to hypokalemia. An electrocardiogram was performed. Demographic data, dialysis characteristics and survival rate were collected. RESULTS: Hypokalemia was present in 15 out of 110 patients (13.6%). The survival rate was lower in the hypokalemic group (p = 0.002). Hypokalemia was only associated with serum levels of albumin and urea, and with the SGA results. CONCLUSION: Low levels of serum potassium were associated to lower survival in PD patients and it seems to be related to malnutrition.

hypokalemia; malnutrition; mortality; peritoneal dialysis; potassium


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