Abstract P217: Impact of Serum Potassium on Mortality and Kidney Outcomes in the Atherosclerosis Risk in Communities (ARIC) Study
Introduction: Little is known about whether abnormal values of serum potassium (K) are associated with mortality and adverse renal outcomes in the general population.
Hypothesis: Abnormal K values are associated with higher risk of mortality and adverse renal outcomes, with stronger associations among persons taking medications that influence K levels.
Methods: We studied 15,641 participants in the ARIC study. Cox proportional hazard regression was used to investigate the association of K at baseline (1987-1989), evaluated categorically (hypokalemia, <3.5 mmol/L; normokalemia, 3.5-5.4 mmol/L; hyperkalemia, ≥5.5 mmol/L) and continuously using linear spline terms (knots at 3.5 and 5.5 mmol/L), with mortality, incident chronic kidney disease (CKD), and end-stage renal disease (ESRD). We also evaluated whether kaliuretic diuretics modified the association between K and adverse outcomes.
Results: Overall, 2.7% of the participants had hypokalemia, 2.1% had hyperkalemia and 19.1% were taking kaliuretic diuretics. In an unadjusted model, both hypo- and hyperkalemia were associated with mortality; in a fully adjusted model, hyperkalemia was significantly associated with mortality (HR: 1.24; 95% CI: 1.04-1.49) while hypokalemia was not (HR: 1.03; 95% CI: 0.89-1.20); however, hypokalemia was associated with mortality among people not taking kaliuretic diuretics (HR: 1.74; 95% CI: 1.31-2.30; p for interaction: <0.001). Neither hypo- nor hyperkalemia was associated with renal outcomes in the adjusted model; however, there was an interaction of kaliuretic diuretic use with hypokalemia, where hypokalemia was associated with significantly higher risk of CKD and ESRD in participants not using kaliuretic diuretics and lower risk in participants using kaliuretic diuretics (CKD: p for interaction: 0.001; ESRD: p for interaction: 0.002).
Conclusions: Abnormal values of K were associated with death and adverse renal outcomes in the general population, particularly among participants not taking kaliuretic diuretics.
Author Disclosures: Y. Chen: None. A.R. Chang: None. J. Coresh: None. M.A. McAdams-Demarco: None. L.A. Inker: None. M.E. Grams: None.
- © 2016 by American Heart Association, Inc.