Analysis Of The Factors Associated With Hypokalemia In Continuous Ambulatory Peritoneal Dialysis Patients

Objective：To investigate the incidence and relative factors of hypokalemia inpatients that received the continuous ambulatory peritoneal dialysis (CAPD).Methods: The investigation was conducted as a cross-sectional study. FromNovember2013to March2014, a total of60candidates including outpatients andinpatients in the Second Affiliated Hospital of Dalian Medical University were enrolled.In this study, we tried to collect and analyze the clinical data and blood biochemicalresults of the patients in their latest visiting. Forty-four patients in whom theconcentration of serum potassium was between3.5mmol/L and5.5mmol/L wereconsidered as the control group, and the other sixteen patients with serum potassiumconcentration lower than3.5mmol/L were considered as the experimental group. Theindicators that were analyzed in this study contained clinical and demographiccharacteristics, nutritional status, markers of inflammation, dialysis related indicators,residual renal function, potassium settlement rate, calcium and phosphorus metabolism,anemia,blood pressure level and so on. Measurement data, categorical data andconstituent ratio were respectively shown as mean±standard deviation, frequency andpercentage. The statistical comparisons between two groups were performed with theindependent t test, chi-square test or Kolmogonov-Smirnov Z test. To explore the riskfactors of hypokalemia, linear correlation analysis was also conducted. Pearsoncorrelation analysis was applied to bivariate normal distribution. However, Spearmancorrelation analysis was used when one or both of two variables didn’t follow a normaldistribution, or both of them were ordered categorical data. Indicators with significant correlation in single factor correlation analysis (P<0.05) were included in Binarylogistic regression analysis to explore the risk factor of hypokalemia.Result: In this study, the overall incidence of hypokalemia was as high as26.67%.The single factor analysis showed that the serum potassium concentration wassignificantly correlated with age, diabetic nephropathy, serum albumin, serumprealbumin, serum phosphorus, calcium-phosphorus product, CRP, peritoneal KT/V,the daily excretion of potassium along with peritoneal fluid and2hD/Pk (2h potassiumdip)(P<0.05). Besides, the level of the serum potassium had a significantly positivecorrelation with serum albumin, serum prealbumin, serum phosphorus,calcium-phosphorus product,it had a significantly negative correlation with age,diabetic nephropathy, CRP, peritoneal KT/V, the daily excretion of potassium alongwith peritoneal fluid and2hD/Pk. However, the serum potassium concentration had nosignificantly statistical correlation with the SGAscore, the type of peritoneal transport,the use of high-glucose peritoneal dialysate, ultrafiltration volume, the daily excretionof urinary potassium, total KT/V, total Ccr, residual renal function,4hD/Pk and so on(P>0.05). In addition, multivariate analysis with Binary logistic regression analysisalso showed that three of the risk factors for hypokalemia were independent,includingdiabetic nephropathy, peritoneal KT/V, the daily excretion of potassium along withperitoneal fluid.Conclusions：1. The single factor analysis shown that the hypokalemia in CAPDwas significantly positive correlation with serum albumin, serum prealbumin, serumphosphorus, calcium-phosphorus product, and it was negative correlation with age,diabetic nephropathy, CRP, peritoneal KT/V, the daily excretion of potassium alongwith peritoneal fluid and2hD/Pk.2.Diabetic nephropathy,peritoneal KT/V and the daily excretion ofpotassium along with peritoneal fluid were the risk factors for the incidence ofhypokalemia in CAPD.