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Relationship between urinary potassium excretion, serum potassium levels and cardiac injury in non-dialysis chronic kidney disease: KoreaN cohort study for Outcome in patients With Chronic Kidney Disease (KNOW-CKD)

Published online by Cambridge University Press:  11 September 2023

Hyang Ki Min Open the ORCID record for Hyang Ki Min [Opens in a new window] ,
Su Ah Sung ,
Ji Yong Jung ,
Yun Kyu Oh ,
Kyu Beck Lee ,
Sue K. Park ,
Kook-Hwan Oh ,
Curie Ahn  and
Sung Woo Lee Open the ORCID record for Sung Woo Lee [Opens in a new window]
Hyang Ki Min
Affiliation:
Department of Internal Medicine, Nowon Eulji Medical Center, Eulji University, Seoul, Republic of Korea
Su Ah Sung
Affiliation:
Department of Internal Medicine, Nowon Eulji Medical Center, Eulji University, Seoul, Republic of Korea
Ji Yong Jung
Affiliation:
Department of Internal Medicine, Graduate School of Medicine, Gachon University, Incheon, Republic of Korea
Yun Kyu Oh
Affiliation:
Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Republic of Korea
Kyu Beck Lee
Affiliation:
Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
Sue K. Park
Affiliation:
Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea Cancer Research Institute, Seoul National University, Seoul, Republic of Korea Department of Biomedical Science, Seoul National University Graduate School, Seoul, Republic of Korea
Kook-Hwan Oh
Affiliation:
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
Curie Ahn
Affiliation:
Department of Internal Medicine, National Medical Center, Seoul, Republic of Korea
Sung Woo Lee*
Affiliation:
Department of Internal Medicine, Uijeongbu Eulji Medical Center, Eulji University, Seoul, 11759, Republic of Korea
*
*Corresponding author: Dr S. W. Lee, email neplsw@gmail.com
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Abstract

Although the cardiovascular benefits of an increased urinary potassium excretion have been suggested, little is known about the potential cardiac association of urinary potassium excretion in patients with chronic kidney disease. In addition, whether the cardiac association of urinary potassium excretion was mediated by serum potassium levels has not been studied yet. We reviewed the data of 1633 patients from a large-scale multicentre prospective Korean study (2011–2016). Spot urinary potassium to creatinine ratio was used as a surrogate for urinary potassium excretion. Cardiac injury was defined as a high-sensitivity troponin T ≥ 14 ng/l. OR and 95 % (CI for cardiac injury were calculated using logistic regression analyses. Of 1633 patients, the mean spot urinary potassium to creatinine ratio was 49·5 (sd 22·6) mmol/g Cr and the overall prevalence of cardiac injury was 33·9 %. Although serum potassium levels were not associated with cardiac injury, per 10 mmol/g Cr increase in the spot urinary potassium to creatinine ratio was associated with decreased odds of cardiac injury: OR 0·917 (95 % CI 0·841, 0·998), P = 0·047) in multivariate logistic regression analysis. In mediation analysis, approximately 6·4 % of the relationship between spot urinary potassium to creatinine ratio and cardiac injury was mediated by serum potassium levels, which was not statistically significant (P = 0·368). Higher urinary potassium excretion was associated with lower odds of cardiac injury, which was not mediated by serum potassium levels.

Keywords

PotassiumTroponinCardiac injuryChronic kidney diseaseMediation
Type
Research Article
Information
British Journal of Nutrition , Volume 131 , Issue 3 , 14 February 2024 , pp. 429 - 437
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Copyright
© The Author(s), 2023. Published by Cambridge University Press on behalf of The Nutrition Society

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