The Effect of Different Serum Potassium Levels on Progression of Chronic Kidney Disease

Objective: Hyperkalemia is the most commonelectrolyte imbalance in chronic kidney disease (CKD). Research within the CKD population suggests a potential link between hyperkalemia, hypokalemia, fluctuations in serum potassium (sK+) levels, and CKD progression.This study aimed to clarify how different sK+ levels affect CKD progression. Material and Methods:eGFR levels were assessed, identifying patients with decreased eGFR. A total of 1171 patients were included .sK+ levels were analyzed in groups, and a Binary Logistic Regression model was employed for GFR decrease prediction. Results: The mean sK+ level was 4.6 ± 0.4 mmol/l. Hyperkalemia was observed in 26.1% of patients, with hypokalemia at only 0.6%. During the follow-up, eGFR levels exhibited a significant decrease. A negative correlation was observed between sK+ level and the final eGFR of patients. Specifically, sK+ levels ranging from 5.0 to 5.5 mmol/l and instances of hyperkalemia were linked with decreased eGFR, while sK+ levels at 3.5-4.0 mmol/l demonstrated a protective effect against eGFR decrease. Adjusting for albumin, calcium, urea levels, ACEi/ARB usage, β-AR blockers intake, and CCB administration in the regression model revealed that sK+ levels at 5.0-5.5 mmol/l and hyperkalemia independently contributed to eGFR decrease. Conversely, sK+ levels at 3.5-4.0 mmol/l emerged as a protective factor against eGFR decrease. Conclusion: Our findings underscore the association of hyperkalemia and sK+ levels at 5.0-5.5 mmol/l with decreased eGFR among CKD patients. Conversely, maintaining sK+ levels at 3.5-4.0 mmol/l appears to mitigate the risk of eGFR decrease. Thus, vigilant sK+ monitoring is crucial in managing CKD effectively.