Time-averaged serum potassium levels and its fluctuation associate with 5-year survival of peritoneal dialysis patients: two-center based study.
Time-averaged serum potassium levels and its fluctuation associate with 5-year survival of peritoneal dialysis patients: two-center based study.
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时间平均血清钾水平及其波动与腹膜透析患者5年生存率的关系：两中心研究
DOI：
10.1038/srep15743
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发表时间：
2015-10-28
影响因子：
4.6
通讯作者：
Shi W
中科院分区：
文献类型：
--
作者：
Li SH;Xie JT;Long HB;Zhang J;Zhou WD;Niu HX;Tang X;Feng ZL;Ye ZM;Zuo YY;Fu L;Wen F;Wang LP;Wang WJ;Shi W
时均血钾能较全面地反映腹膜透析（PD）期间血钾水平的变化。然而，时间平均血清钾水平的波动与PD患者的长期生存的关系仍然未知。在这项回顾性研究中，我们纳入了2007年1月1日至2012年10月31日期间在2个中心发生的357例PD患者，随访至2014年10月31日。我们的数据表明，这是较低的时间平均血清钾水平，而不是基线血清钾水平与死亡的高风险。标准差（SD）较高的患者全因死亡率（p= 0.016）和心血管死亡率（p= 0.041）显著较差。在时间平均血清钾水平低于4.0 mEq/L的患者中，较低的平均值比其SD对预测死亡风险更重要。相比之下，与对照组相比，时间平均血清钾水平高于4.0 mEq/L的患者，血清钾SD < 0.54 mEq/L的患者，全因死亡率和心血管死亡率的3年和5年生存率均较高。我们的数据清楚地表明，时间平均血清钾及其波动对PD患者的高死亡风险有不成比例的贡献。
The time-averaged serum potassium was more comprehensive to reflect the all-time changes of serum potassium levels during peritoneal dialysis (PD). However, the association of fluctuation of time-averaged serum potassium level with long-time survival of PD patients remains unknown. In this retrospective study, we included 357 incident PD patients in 2 centers from January 1, 2007 to October 31, 2012 with follow-up through October 31, 2014. Our data demonstrated that it was the lower time-averaged serum potassium level rather than baseline of serum potassium level that was associated with high risk of death. Patients with higher standard deviation (SD) had significantly poorer all-cause (p= 0.016) and cardiovascular mortality (p= 0.041). Among the patients with time-averaged serum potassium levels below 4.0 mEq/L, a lower mean value was more important than its SD to predict death risk. In contrast, the patients with time-averaged serum potassium levels above 4.0 mEq/L, those with serum potassium SD < 0.54 mEq/L, exhibited a higher 3-year and 5-year survival rate for both all-cause and cardiovascular mortality compared to the control groups. Our data clearly suggested both time-averaged serum potassium and its fluctuation contributed disproportionately to the high death risk in PD patients.