Urinary Potassium excretion and progression of CKD

Hyung Woo Kim, Jung Tak Park, Tae Hyun Yoo, Joongyub Lee, Wookyung Chung, Kyu Beck Lee, Dong Wan Chae, Curie Ahn, Shin Wook Kang, Kyu Hun Choi, Seung Hyeok Han

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background and objectives Data on whether low or high urinary potassium excretion is associated with poor kidney outcome have been conflicting. The aim of this study was to clarify the association between urinary potassium excretion and CKD progression. Design, setting, participants, & measurements We investigated the relationship between lower urinary potassiumexcretion andCKDprogression andcompared threeurinarypotassiumindicesamong1821patients from the Korean Cohort Study for Outcome in Patients with CKD. Urinary potassium excretion was determined using spot urinary potassium-to-creatinine ratio, spot urinary potassium concentration, and 24-hour urinary potassiumexcretion. Patientswere categorized into four groups according to quartiles of each urinary potassium excretion metric. The study end point was a composite of a ≥50% decrease in eGFR from baseline values and ESKD. Results During 5326 person-years of follow-up, the primary outcome occurred in 392 (22%) patients. In a multivariable cause-specific hazard model, lower urinary potassium-to-creatinine ratio was associated with higher risk of CKD progression (adjusted hazard ratio, 1.47; 95% confidence interval, 1.01 to 2.12) comparing the lowest quartile with the highest quartile. Sensitivity analyses with other potassium metrics also showed consistent results in 855 patients who completed 24-hour urinary collections: adjusted hazard ratios comparing the lowest quartile with the highest quartile were 3.05 (95% confidence interval, 1.54 to 6.04) for 24-hour urinary potassium excretion, 1.95 (95% confidence interval, 1.05 to 3.62) for spot urinary potassium-to-creatinine ratio, and 3.79 (95% confidence interval, 1.51 to 9.51) for spot urinary potassium concentration. Conclusions Low urinary potassium excretion is associated with progression of CKD.

Original languageEnglish
Pages (from-to)330-340
Number of pages11
JournalClinical Journal of the American Society of Nephrology
Volume14
Issue number3
DOIs
Publication statusPublished - 2019 Mar 7

Fingerprint

Potassium
Confidence Intervals
Creatinine
Proportional Hazards Models
Cohort Studies
Kidney

All Science Journal Classification (ASJC) codes

  • Epidemiology
  • Critical Care and Intensive Care Medicine
  • Nephrology
  • Transplantation

Cite this

Kim, Hyung Woo ; Park, Jung Tak ; Yoo, Tae Hyun ; Lee, Joongyub ; Chung, Wookyung ; Lee, Kyu Beck ; Chae, Dong Wan ; Ahn, Curie ; Kang, Shin Wook ; Choi, Kyu Hun ; Han, Seung Hyeok. / Urinary Potassium excretion and progression of CKD. In: Clinical Journal of the American Society of Nephrology. 2019 ; Vol. 14, No. 3. pp. 330-340.
@article{f32a010927974522abf823387ed1eebc,
title = "Urinary Potassium excretion and progression of CKD",
abstract = "Background and objectives Data on whether low or high urinary potassium excretion is associated with poor kidney outcome have been conflicting. The aim of this study was to clarify the association between urinary potassium excretion and CKD progression. Design, setting, participants, & measurements We investigated the relationship between lower urinary potassiumexcretion andCKDprogression andcompared threeurinarypotassiumindicesamong1821patients from the Korean Cohort Study for Outcome in Patients with CKD. Urinary potassium excretion was determined using spot urinary potassium-to-creatinine ratio, spot urinary potassium concentration, and 24-hour urinary potassiumexcretion. Patientswere categorized into four groups according to quartiles of each urinary potassium excretion metric. The study end point was a composite of a ≥50{\%} decrease in eGFR from baseline values and ESKD. Results During 5326 person-years of follow-up, the primary outcome occurred in 392 (22{\%}) patients. In a multivariable cause-specific hazard model, lower urinary potassium-to-creatinine ratio was associated with higher risk of CKD progression (adjusted hazard ratio, 1.47; 95{\%} confidence interval, 1.01 to 2.12) comparing the lowest quartile with the highest quartile. Sensitivity analyses with other potassium metrics also showed consistent results in 855 patients who completed 24-hour urinary collections: adjusted hazard ratios comparing the lowest quartile with the highest quartile were 3.05 (95{\%} confidence interval, 1.54 to 6.04) for 24-hour urinary potassium excretion, 1.95 (95{\%} confidence interval, 1.05 to 3.62) for spot urinary potassium-to-creatinine ratio, and 3.79 (95{\%} confidence interval, 1.51 to 9.51) for spot urinary potassium concentration. Conclusions Low urinary potassium excretion is associated with progression of CKD.",
author = "Kim, {Hyung Woo} and Park, {Jung Tak} and Yoo, {Tae Hyun} and Joongyub Lee and Wookyung Chung and Lee, {Kyu Beck} and Chae, {Dong Wan} and Curie Ahn and Kang, {Shin Wook} and Choi, {Kyu Hun} and Han, {Seung Hyeok}",
year = "2019",
month = "3",
day = "7",
doi = "10.2215/CJN.07820618",
language = "English",
volume = "14",
pages = "330--340",
journal = "Clinical journal of the American Society of Nephrology : CJASN",
issn = "1555-9041",
publisher = "American Society of Nephrology",
number = "3",

}

Kim, HW, Park, JT, Yoo, TH, Lee, J, Chung, W, Lee, KB, Chae, DW, Ahn, C, Kang, SW, Choi, KH & Han, SH 2019, 'Urinary Potassium excretion and progression of CKD', Clinical Journal of the American Society of Nephrology, vol. 14, no. 3, pp. 330-340. https://doi.org/10.2215/CJN.07820618

Urinary Potassium excretion and progression of CKD. / Kim, Hyung Woo; Park, Jung Tak; Yoo, Tae Hyun; Lee, Joongyub; Chung, Wookyung; Lee, Kyu Beck; Chae, Dong Wan; Ahn, Curie; Kang, Shin Wook; Choi, Kyu Hun; Han, Seung Hyeok.

In: Clinical Journal of the American Society of Nephrology, Vol. 14, No. 3, 07.03.2019, p. 330-340.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Urinary Potassium excretion and progression of CKD

AU - Kim, Hyung Woo

AU - Park, Jung Tak

AU - Yoo, Tae Hyun

AU - Lee, Joongyub

AU - Chung, Wookyung

AU - Lee, Kyu Beck

AU - Chae, Dong Wan

AU - Ahn, Curie

AU - Kang, Shin Wook

AU - Choi, Kyu Hun

AU - Han, Seung Hyeok

PY - 2019/3/7

Y1 - 2019/3/7

N2 - Background and objectives Data on whether low or high urinary potassium excretion is associated with poor kidney outcome have been conflicting. The aim of this study was to clarify the association between urinary potassium excretion and CKD progression. Design, setting, participants, & measurements We investigated the relationship between lower urinary potassiumexcretion andCKDprogression andcompared threeurinarypotassiumindicesamong1821patients from the Korean Cohort Study for Outcome in Patients with CKD. Urinary potassium excretion was determined using spot urinary potassium-to-creatinine ratio, spot urinary potassium concentration, and 24-hour urinary potassiumexcretion. Patientswere categorized into four groups according to quartiles of each urinary potassium excretion metric. The study end point was a composite of a ≥50% decrease in eGFR from baseline values and ESKD. Results During 5326 person-years of follow-up, the primary outcome occurred in 392 (22%) patients. In a multivariable cause-specific hazard model, lower urinary potassium-to-creatinine ratio was associated with higher risk of CKD progression (adjusted hazard ratio, 1.47; 95% confidence interval, 1.01 to 2.12) comparing the lowest quartile with the highest quartile. Sensitivity analyses with other potassium metrics also showed consistent results in 855 patients who completed 24-hour urinary collections: adjusted hazard ratios comparing the lowest quartile with the highest quartile were 3.05 (95% confidence interval, 1.54 to 6.04) for 24-hour urinary potassium excretion, 1.95 (95% confidence interval, 1.05 to 3.62) for spot urinary potassium-to-creatinine ratio, and 3.79 (95% confidence interval, 1.51 to 9.51) for spot urinary potassium concentration. Conclusions Low urinary potassium excretion is associated with progression of CKD.

AB - Background and objectives Data on whether low or high urinary potassium excretion is associated with poor kidney outcome have been conflicting. The aim of this study was to clarify the association between urinary potassium excretion and CKD progression. Design, setting, participants, & measurements We investigated the relationship between lower urinary potassiumexcretion andCKDprogression andcompared threeurinarypotassiumindicesamong1821patients from the Korean Cohort Study for Outcome in Patients with CKD. Urinary potassium excretion was determined using spot urinary potassium-to-creatinine ratio, spot urinary potassium concentration, and 24-hour urinary potassiumexcretion. Patientswere categorized into four groups according to quartiles of each urinary potassium excretion metric. The study end point was a composite of a ≥50% decrease in eGFR from baseline values and ESKD. Results During 5326 person-years of follow-up, the primary outcome occurred in 392 (22%) patients. In a multivariable cause-specific hazard model, lower urinary potassium-to-creatinine ratio was associated with higher risk of CKD progression (adjusted hazard ratio, 1.47; 95% confidence interval, 1.01 to 2.12) comparing the lowest quartile with the highest quartile. Sensitivity analyses with other potassium metrics also showed consistent results in 855 patients who completed 24-hour urinary collections: adjusted hazard ratios comparing the lowest quartile with the highest quartile were 3.05 (95% confidence interval, 1.54 to 6.04) for 24-hour urinary potassium excretion, 1.95 (95% confidence interval, 1.05 to 3.62) for spot urinary potassium-to-creatinine ratio, and 3.79 (95% confidence interval, 1.51 to 9.51) for spot urinary potassium concentration. Conclusions Low urinary potassium excretion is associated with progression of CKD.

UR - http://www.scopus.com/inward/record.url?scp=85062595694&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85062595694&partnerID=8YFLogxK

U2 - 10.2215/CJN.07820618

DO - 10.2215/CJN.07820618

M3 - Article

C2 - 30765533

AN - SCOPUS:85062595694

VL - 14

SP - 330

EP - 340

JO - Clinical journal of the American Society of Nephrology : CJASN

JF - Clinical journal of the American Society of Nephrology : CJASN

SN - 1555-9041

IS - 3

ER -