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Cited by 346

The DOI matches its Crossref record; 9 of the 9 references it cites were found in a registry or an index.

Serum potassium and adverse outcomes across the range of kidney function: a CKD Prognosis Consortium meta-analysis

Open access
Kovesdy, Csaba P, Matsushita, Kunihiro, Sang, Yingying, Brunskill, Nigel J, Carrero, Juan J, Chodick, Gabriel, Hasegawa, Takeshi, Heerspink, Hiddo L, Hirayama, Atsushi, Landman, Gijs W D, Levin, Adeera, Nitsch, Dorothea, Wheeler, David C, Coresh, Josef, Hallan, Stein I, Shalev, Varda, Grams, Morgan E, CKD Prognosis Consortium, Astor, Brad, Appel, Larry, Greene, Tom, Chen, Teresa, Chalmers, John, Woodward, Mark, Arima, Hisatomi, Perkovic, Vlado, Levin, Adeera, Djurdjev, Ognjenka, Zhang, Luxia, Liu, Lisheng, Zhao, Minghui, Wang, Fang, Wang, Jinwei, Levin, Adeera, Djurdjev, Ognjenka, Tang, Mila, Iso, Hiroyasu, Yamagishi, Kazumasa, Umesawa, Mitsumasa, Muraki, Isao, Fukagawa, Masafumi, Maruyama, Shoichi, Hamano, Takayuki, Hasegawa, Takeshi, Fujii, Naohiko, Wheeler, David, Emberson, John, Townend, John, Landray, Martin, Green, Jamie, Kirchner, H Lester, Chang, Alex R, Cirillo, Massimo, Jee, Sun Ha, Kimm, Heejin, Mok, Yejin, Chodick, Gabriel, Shalev, Varda, Wetzels, Jack F M, Blankestijn, Peter J, van Zuilen, Arjan D, Bots, M, Sarnak, Mark, Inker, Lesley, Nitsch, Dorothea, Roderick, Paul, Fletcher, Astrid, Bottinger, Erwin, Nadkarni, Girish N, Ellis, Stephen B, Nadukuru, Rajiv, Sang, Yingying, Brunskill, Nigel, Major, Rupert, Shepherd, David, Medcalf, James, Gansevoort, Ron T, Bakker, Stephan J L, Heerspink, Hiddo J Lambers, Jassal, Simerjot K, Bergstrom, Jaclyn, Ix, Joachim H, Barrett-Connor, Elizabeth, Kovesdy, Csaba, Kalantar-Zadeh, Kamyar, Heerspink, Hiddo J Lambers, de Zeeuw, Dick, Brenner, Barry, Carrero, Juan J, Gasparini, Alessandro, Elinder, Carl-Gustaf, Barany, Peter, Evans, Marie, Segelmark, Mårten, Stendahl, Maria, Schön, Staffan, Tangri, Navdeep, Sud, Maneesh, Naimark, David, Wen, Chi-Pang, Tsao, Chwen-Keng, Tsai, Min-Kugng, Chen, Chien-Hua, Konta, Tsuneo, Hirayama, Atsushi, Ichikawa, Kazunobu, Bilo, Henk J G, Landman, Gijs W D, van Hateren, Kornelis J J, Kleefstra, Nanne, Coresh, Josef, Gansevoort, Ron T, Grams, Morgan E, Hallan, Stein, Kovesdy, Csaba P, Levey, Andrew S, Matsushita, Kunihiro, Shalev, Varda, Woodward, Mark, Ballew, Shoshana H, Chen, Jingsha, Coresh, Josef, Grams, Morgan E, Kwak, Lucia, Matsushita, Kunihiro, Sang, Yingying, Woodward, Mark·2018·European Heart Journal
DOI 10.1093/eurheartj/ehy100
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Abstract

Aims: Both hypo- and hyperkalaemia can have immediate deleterious physiological effects, and less is known about long-term risks. The objective was to determine the risks of all-cause mortality, cardiovascular mortality, and end-stage renal disease associated with potassium levels across the range of kidney function and evaluate for consistency across cohorts in a global consortium. Methods and results: We performed an individual-level data meta-analysis of 27 international cohorts [10 general population, 7 high cardiovascular risk, and 10 chronic kidney disease (CKD)] in the CKD Prognosis Consortium. We used Cox regression followed by random-effects meta-analysis to assess the relationship between baseline potassium and adverse outcomes, adjusted for demographic and clinical characteristics, overall and across strata of estimated glomerular filtration rate (eGFR) and albuminuria. We included 1 217 986 participants followed up for a mean of 6.9 years. The average age was 55 ± 16 years, average eGFR was 83 ± 23 mL/min/1.73 m2, and 17% had moderate- to-severe increased albuminuria levels. The mean baseline potassium was 4.2 ± 0.4 mmol/L. The risk of serum potassium of >5.5 mmol/L was related to lower eGFR and higher albuminuria. The risk relationship between potassium levels and adverse outcomes was U-shaped, with the lowest risk at serum potassium of 4-4.5 mmol/L. Compared with a reference of 4.2 mmol/L, the adjusted hazard ratio for all-cause mortality was 1.22 [95% confidence interval (CI) 1.15-1.29] at 5.5 mmol/L and 1.49 (95% CI 1.26-1.76) at 3.0 mmol/L. Risks were similar by eGFR, albuminuria, renin-angiotensin-aldosterone system inhibitor use, and across cohorts. Conclusions: Outpatient potassium levels both above and below the normal range are consistently associated with adverse outcomes, with similar risk relationships across eGFR and albuminuria.

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Authors
Kovesdy, C. P., Matsushita, K., Sang, Y., Brunskill, N. J., Carrero, J. J., Chodick, G., Hasegawa, T., Heerspink, H. L., Hirayama, A., Landman, G. W. D., Levin, A., Nitsch, D., Wheeler, D. C., Coresh, J., Hallan, S. I., Shalev, V., Grams, M. E., CKD Prognosis Consortium, Astor, B., Appel, L., Greene, T., Chen, T., Chalmers, J., Woodward, M., Arima, H., Perkovic, V., Levin, A., Djurdjev, O., Zhang, L., Liu, L., Zhao, M., Wang, F., Wang, J., Levin, A., Djurdjev, O., Tang, M., Iso, H., Yamagishi, K., Umesawa, M., Muraki, I., Fukagawa, M., Maruyama, S., Hamano, T., Hasegawa, T., Fujii, N., Wheeler, D., Emberson, J., Townend, J., Landray, M., Green, J., Kirchner, H. L., Chang, A. R., Cirillo, M., Jee, S. H., Kimm, H., Mok, Y., Chodick, G., Shalev, V., Wetzels, J. F. M., Blankestijn, P. J., van Zuilen, A. D., Bots, M., Sarnak, M., Inker, L., Nitsch, D., Roderick, P., Fletcher, A., Bottinger, E., Nadkarni, G. N., Ellis, S. B., Nadukuru, R., Sang, Y., Brunskill, N., Major, R., Shepherd, D., Medcalf, J., Gansevoort, R. T., Bakker, S. J. L., Heerspink, H. J. L., Jassal, S. K., Bergstrom, J., Ix, J. H., Barrett-Connor, E., Kovesdy, C., Kalantar-Zadeh, K., Heerspink, H. J. L., de Zeeuw, D., Brenner, B., Carrero, J. J., Gasparini, A., Elinder, C.-G., Barany, P., Evans, M., Segelmark, M., Stendahl, M., Schön, S., Tangri, N., Sud, M., Naimark, D., Wen, C.-P., Tsao, C.-K., Tsai, M.-K., Chen, C.-H., Konta, T., Hirayama, A., Ichikawa, K., Bilo, H. J. G., Landman, G. W. D., van Hateren, K. J. J., Kleefstra, N., Coresh, J., Gansevoort, R. T., Grams, M. E., Hallan, S., Kovesdy, C. P., Levey, A. S., Matsushita, K., Shalev, V., Woodward, M., Ballew, S. H., Chen, J., Coresh, J., Grams, M. E., Kwak, L., Matsushita, K., Sang, Y., & Woodward, M.
Venue
European Heart Journal
Publisher
Oxford University Press (OUP)
Published
2018-03-14
Volume
39
Issue
17
Pages
1535-1542
ISSN
  • 0195-668X (ISSN-L)
  • 1522-9645
DOI
10.1093/eurheartj/ehy100
OpenAlex
W2790169725
Cited by
346
References
9
FWCI
22.32
Type
journal article
Language
en
Open access
bronze

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