Prevalence and Management of Hypokalemia in Peritoneal Dialysis Patients in Qatar.
Journal
International journal of nephrology
ISSN: 2090-214X
Titre abrégé: Int J Nephrol
Pays: United States
ID NLM: 101546753
Informations de publication
Date de publication:
2019
2019
Historique:
received:
22
07
2019
revised:
04
11
2019
accepted:
23
11
2019
entrez:
14
1
2020
pubmed:
14
1
2020
medline:
14
1
2020
Statut:
epublish
Résumé
Hypokalemia is common in patients undergoing peritoneal dialysis (PD). It is associated with increased cardiovascular and all-cause mortality. Treatment usually includes oral potassium supplements, which are poorly tolerated. Our aim was to evaluate the prevalence of hypokalemia in PD patients in Qatar and to improve treatment measures. All PD patients in Qatar with persistent hypokalemia and on potassium supplement were included. We performed a root cause analysis, and a management pathway was created. We collected data before (Period 1) and after (Period 2) implementation of the new pathway. A total of 143 patients with a mean age of 54 years (range 21-82 years) were included in the study. Initial results of Period 1 showed hypokalemia in 48 patients (34%); of these, 14 (29%) had hypomagnesemia. Hypokalemia resolved in 10 of the patients after correction of their hypomagnesemia. The remaining 4 patients continued to require potassium supplementation despite correction of their hypomagnesemia. We started spironolactone (25 mg daily) in 13 of the hypokalemia patients. After 3 months, their mean serum potassium level improved from 3.2 ± 0.3 mmol/L to 3.9 ± 0.4 mmol/L ( Our study showed that hypokalemia is a prevalent problem in PD patients in Qatar. Hypomagnesemia is a significant contributing factor to hypokalemia in PD and correcting it leads to improvement of hypokalemia. Addition of spironolactone is safe and effective in treating hypokalemia. Implementing a holistic pathway led to a significant improvement in hypokalemia prevalence in PD patients.
Identifiants
pubmed: 31929904
doi: 10.1155/2019/1875358
pmc: PMC6935807
doi:
Types de publication
Journal Article
Langues
eng
Pagination
1875358Informations de copyright
Copyright © 2019 Abdullah Hamad et al.
Déclaration de conflit d'intérêts
The authors declare that they have no conflicts of interest.
Références
Saudi J Kidney Dis Transpl. 2012 May;23(3):507-12
pubmed: 22569436
J Clin Hypertens (Greenwich). 2014 Sep;16(9):658-63
pubmed: 25052724
Int Urol Nephrol. 2003;35(3):429-34
pubmed: 15160552
J Pathol. 2005 May;206(1):46-51
pubmed: 15772943
J Am Coll Cardiol. 2014 Feb 18;63(6):528-36
pubmed: 24184249
Ther Apher Dial. 2015 Feb;19(1):81-6
pubmed: 25196890
J Clin Hypertens (Greenwich). 2011 Sep;13(9):644-8
pubmed: 21896143
Am J Kidney Dis. 2005 Jul;46(1):94-101
pubmed: 15983962
J Bras Nefrol. 2012 Oct-Dec;34(4):349-54
pubmed: 23318823
Perit Dial Int. 2017 1-2;37(1):63-69
pubmed: 27282853
J Am Soc Nephrol. 2007 Oct;18(10):2649-52
pubmed: 17804670
Semin Dial. 2014 Jul-Aug;27(4):328-32
pubmed: 24499322
J Clin Hypertens (Greenwich). 2016 Feb;18(2):121-8
pubmed: 26224543
J Am Soc Nephrol. 2014 May;25(5):1094-102
pubmed: 24335969
Cardiology. 2009;114(1):32-8
pubmed: 19342857
Am J Kidney Dis. 2005 Jul;46(1):128-35
pubmed: 15983966
Ren Fail. 2007;29(5):603-5
pubmed: 17654324
Clin J Am Soc Nephrol. 2012 Aug;7(8):1272-84
pubmed: 22626960
Perit Dial Int. 1996 Nov-Dec;16(6):652
pubmed: 8981546
PLoS One. 2016 Mar 29;11(3):e0152488
pubmed: 27023783
Med Hypotheses. 2017 Oct;108:128-132
pubmed: 29055386
Am J Kidney Dis. 1985 Sep;6(3):173-6
pubmed: 3898826
PLoS One. 2017 Nov 10;12(11):e0187269
pubmed: 29125879
PLoS One. 2014 Jan 27;9(1):e86750
pubmed: 24475176
Electrolyte Blood Press. 2007 Dec;5(2):102-10
pubmed: 24459508