Factors associated with Hypokalemia in Continuous Ambulatory Peritoneal Dialysis Patients

Abstract

Hypokalemia is a frequent problem in patients on continuous ambulatory peritoneal dialysis (CAPD) and is affected by multiple factors. To evaluate factors associated with hypokalemia, we studied 68 patients on maintenance CAPD treatment for at least six months. In univariate analysis, patients with hypokalemia were associated with older age and the presence of diabetes mellitus. Serum albumin, calcium-phosphate product, triglyceride, body mass index, protein nitrogen appearance, and lean body mass assessed by creatinine kinetics were significantly lower as compared to those without hypokalemia. Serum C-reactive protein was significantly higher in the patients with hypokalemia. Multivariate stepwise linear regression analysis revealed that the serum albumin level and the ultrafiltration volume at the peritoneal equilibration test were independent factors associated with hypokalemia. This suggests that the serum potassium level may be an important nutritional marker in CAPD patients. Further longitudinal investigation is needed to clarify this relationship.

Keywords: Continuous ambulatory peritoneal dialysis; Hypokalemia; Nutritional status; Potassium.

Fig. 1

Distribution of patient serum potassium levels.

Fig. 2

Correlation between serum potassium levels and ultrafiltration volumes at peritoneal equilibration test (PET).

Fig. 3

Correlation between serum potassium levels and serum albumin levels.

Fig. 4

Correlation between serum potassium levels and 4-hour dialysate to plasma (D/P) creatinines.

Fig. 5

Correlation between serum potassium levels and C-reactive protein levels.