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Low Serum Potassium Levels Increase the Infectious-Caused Mortality in Peritoneal Dialysis Patients: A Propensity-Matched Score Study

Author

Listed:
  • Silvia Carreira Ribeiro
  • Ana Elizabeth Figueiredo
  • Pasqual Barretti
  • Roberto Pecoits-Filho
  • Thyago Proenca de Moraes
  • all centers that contributed to the BRAZPD II study

Abstract

Background and Objectives: Hypokalemia has been consistently associated with high mortality rate in peritoneal dialysis. However, studies investigating if hypokalemia is acting as a surrogate marker of comorbidities or has a direct effect in the risk for mortality have not been studied. Thus, the aim of this study was to analyze the effect of hypokalemia on overall and cause-specific mortality. Design, Setting, Participants and Measurements: This is an analysis of BRAZPD II, a nationwide prospective cohort study. All patients on PD for longer than 90 days with measured serum potassium levels were used to verify the association of hypokalemia with overall and cause-specific mortality using a propensity match score to reduce selection bias. In addition, competing risks were also taken into account for the analysis of cause-specific mortality. Results: There was a U-shaped relationship between time-averaged serum potassium and all-cause mortality of PD patients. Cardiovascular disease was the main cause of death in the normokalemic group with 133 events (41.8%) followed by PD-non related infections, n=105 (33.0%). Hypokalemia was associated with a 49% increased risk for CV mortality after adjustments for covariates and the presence of competing risks (SHR 1.49; CI95% 1.01-2.21). In contrast, in the group of patients with K

Suggested Citation

  • Silvia Carreira Ribeiro & Ana Elizabeth Figueiredo & Pasqual Barretti & Roberto Pecoits-Filho & Thyago Proenca de Moraes & all centers that contributed to the BRAZPD II study, 2015. "Low Serum Potassium Levels Increase the Infectious-Caused Mortality in Peritoneal Dialysis Patients: A Propensity-Matched Score Study," PLOS ONE, Public Library of Science, vol. 10(6), pages 1-13, June.
    • Handle: RePEc:plo:pone00:0127453
    DOI: 10.1371/journal.pone.0127453
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    References listed on IDEAS

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    1. Kewei Ming & Paul R. Rosenbaum, 2000. "Substantial Gains in Bias Reduction from Matching with a Variable Number of Controls," Biometrics, The International Biometric Society, vol. 56(1), pages 118-124, March.
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