The Relation of Serum Potassium Concentration with Cardiovascular Events and Mortality in Community-Living Individuals
The Relation of Serum Potassium Concentration with Cardiovascular Events and Mortality in Community-Living Individuals
复制标题
DOI：
10.2215/cjn.06290616
复制
发表时间：
2017-02-01
影响因子：
9.8
通讯作者：
Ix, Joachim H.
中科院分区：
文献类型：
--
作者：
Hughes-Austin, Jan M.;Rifkin, Dena E.;Ix, Joachim H.
背景和目的高钾血症与慢性肾病患者和患有急性疾病的住院患者的不良结局相关。关于社区生活人群中的高钾血症、心血管疾病（CVD）和死亡率知之甚少。在两个大型观察队列的汇总分析中，我们研究了血清钾浓度与CVD事件和死亡率之间的关系，以及钾改变药物和eGFR ≥ 5.0 mEq/L是否具有更高的全因死亡风险（风险比，1.41; 95%置信区间，1.12 - 1.76），CVD死亡（风险比，1.50; 95%置信区间，1.00至2.26），和非心血管疾病死亡（风险比，1.40; 95%置信区间，1.07至1.83）在充分调整的模型。血清钾与这些终点的相关性在利尿剂使用者中存在差异（P-相互作用= 5.0 mEq/L且同时使用利尿剂者与未使用利尿剂者相比，每个终点的风险更高。结论血清钾浓度>= 5.0 mEq/L与社区生活个体的全因死亡率、CVD死亡和非CVD死亡相关;在利尿剂使用者中相关性更强。钾维持在正常范围内是否可以改善临床结果需要进一步研究。
Background and objectives Hyperkalemia is associated with adverse outcomes in patients with CKD and in hospitalized patients with acute medical conditions. Little is known regarding hyperkalemia, cardiovascular disease (CVD), and mortality in community-living populations. In a pooled analysis of two large observational cohorts, we investigated associations between serum potassium concentrations and CVD events and mortality, and whether potassium-altering medications and eGFR= 5.0 mEq/L were at higher risk for all-cause mortality (hazard ratio, 1.41; 95% confidence interval, 1.12 to 1.76), CVD death (hazard ratio, 1.50; 95% confidence interval, 1.00 to 2.26), and non-CVD death (hazard ratio, 1.40; 95% confidence interval, 1.07 to 1.83) in fully adjusted models. Associations of serum potassium with these end points differed among diuretic users (P-interaction= 5.0 mEq/L and were concurrently using diuretics were at higher risk of each end point compared with those not using diuretics.Conclusions Serum potassium concentration >= 5.0 mEq/L was associated with all-cause mortality, CVD death, and non-CVD death in community-living individuals; associations were stronger in diuretic users. Whether maintenance of potassium within the normal range may improve clinical outcomes requires future study.