Dietary Potassium Intake and All-Cause Mortality in Adults Treated with Hemodialysis

被引：53

作者：

Bernier-Jean, Amelie ^{[1
]}

Wong, Germaine ^{[1
]}

Saglimbene, Valeria ^{[1
,2
]}

Ruospo, Marinella ^{[2
]}

Palmer, Suetonia C. ^{[3
]}

Natale, Patrizia ^{[2
]}

Garcia-Larsen, Vanessa ^{[4
]}

Johnson, David W. ^{[5
,6
]}

Tonelli, Marcello ^{[7
]}

Hegbrant, Jorgen ^{[8
]}

Craig, Jonathan C. ^{[9
]}

Teixeira-Pinto, Armando ^{[1
]}

Strippoli, Giovanni F. M. ^{[1
,2
]}

机构：

[1] Univ Sydney, Fac Med & Hlth, Sch Publ Hlth, Sydney, NSW, Australia

[2] Univ Bari, Dept Emergency & Organ Transplantat, Bari, Italy

[3] Univ Otago, Dept Med, Christchurch, New Zealand

[4] Johns Hopkins Bloomberg Sch Publ Hlth, Dept Int Hlth, Program Human Nutr, Baltimore, MD USA

[5] Princess Alexandra Hosp, Dept Nephrol, Brisbane, Qld, Australia

[6] Univ Queensland, Australasian Kidney Trials Network, Brisbane, Qld, Australia

[7] Univ Calgary, Calgary, AB, Canada

[8] Lund Univ, Dept Nephrol, Lund, Sweden

[9] Flinders Univ S Australia, Coll Med & Publ Hlth, Adelaide, SA, Australia

来源：

CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY | 2021年 / 16卷 / 12期

基金：

澳大利亚国家健康与医学研究理事会;

关键词：

hemodialysis; nutrition; mortality; potassium; dietary; cohort studies; diet; SERUM POTASSIUM; SURVIVAL; RESTRICTIONS; PHOSPHORUS; PRODUCTS; POULTRY; IMPACT; MEAT;

D O I：

10.2215/CJN.08360621

中图分类号：

R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

1002 ; 100201 ;

摘要：

Background and objectives Dietary potassium restriction in people receiving maintenance hemodialysis is standard practice and is recommended in guidelines, despite a lack of evidence. We aimed to assess the association between dietary potassium intake and mortality and whether hyperkalemia mediates this association. Design, setting, participants, & measurements A total of 8043 adults undergoing maintenance hemodialysis in Europe and South America were included in the DIETary intake, death and hospitalization in adults with end-stage kidney disease treated with HemoDialysis (DIET-HD) study. We measured baseline potassium intake from the Global Allergy and Asthma European Network food frequency questionnaire and performed time-to-event and mediation analyses. Results The median potassium intake at baseline was 3.5 (interquartile range, 2.5-5.0) g/d. During a median follow-up of 4.0 years (25,890 person-years), we observed 2921 (36%) deaths. After adjusting for baseline characteristics, including cardiac disease and food groups, dietary potassium intake was not associated with all-cause mortality (per 1 g/d higher dietary potassium intake: hazard ratio, 1.00; 95% confidence interval [95% CI],0.95 to 1.05). A mediation analysis showed no association of potassium intake with mortality, either through or independent of serum potassium (hazard ratio, 1.00; 95% CI, 1.00 to 1.00 and hazard ratio, 1.01; 95% CI, 0.96 to1.06, respectively). Potassium intake was not significantly associated with serum levels (0.03; 95% CI, -0.01 to0.07 mEq/L per 1 g/d higher dietary potassium intake) or the prevalence of hyperkalemia (=6.0 mEq/L) at baseline (odds ratio, 1.11; 95% CI, 0.89 to 1.37 per 1 g/d higher dietary potassium intake). Hyperkalemia was associated with cardiovascular death (hazard ratio, 1.23; 95% CI, 1.03 to 1.48). Conclusions Higher dietary intake of potassium is not associated with hyperkalemia or death in patients treated with hemodialysis

引用

页码：1851 / 1861

页数：11

共 48 条

[11]

Jackson H., 2003, EDTNA ERCA J, V29, P23, DOI 10.1111/j.1755-6686.2003.tb00270.x

[12] Dietary Restrictions in Dialysis Patients: Is There Anything Left to Eat? [J].