Objective: To investigate the prevalence and associated factors of hyperkalemia in dialysis patients. Methods: Patients underwent hemodialysis (HD) and peritoneal dialysis (PD) from multi-center databases were recruited from January 2017 to December 2019, and those aged ≥18 years and with dialysis duration ≥3 months were included to analyze the prevalence and related factors of hyperkalemia. Results: A total of 12 364 patients were enrolled in the study, and 6 836 cases were men. The average age of the patients was (51±15) years. Among these patients, 4 230 cases underwent HD while 8 134 received PD. Hyperkalemia was detected in 20.7% (2 554/12 364) of the patients while hypokalemia was found in 17.0%(2 102/12 364) of the patients. Multivariate logistic regression showed that HD (OR=2.25, 95%CI: 1.54-3.30), diabetes mellitus (DM) (OR=1.65, 95%CI: 1.17-2.32), high body mass index (BMI) (OR=1.06, 95%CI: 1.03-1.09), high levels of serum albumin (OR=1.04, 95%CI: 1.01-1.07) and phosphorus (OR=3.12, 95%CI: 2.44-4.00), low levels of serum bicarbonate (OR=0.89, 95%CI: 0.87-0.92), triglycerides (OR=0.76, 95%CI: 0.68-0.85) and creatinine (OR=0.95, 95%CI: 0.90-0.99), usage of angiotensin converting enzyme inhibitor/Angiotensin Ⅱ receptor antagonist (ACEI/ARB, OR=1.38, 95%CI: 1.11-1.72) and beta-blocker (OR=1.32, 95%CI: 1.07-1.64) were associated with hyperkalemia. Conclusions: Hyperkalemia occurred in 20.7% of the dialysis patients. HD, DM, high BMI, high levels of serum albumin and phosphorus, low levels of serum bicarbonate, triglycerides and creatinine, use of ACEI/ARB were associated with hyperkalemia.
目的: 探讨透析患者高钾血症的发生率及其相关因素。 方法: 纳入2017年1月至2019年12月全国多中心血液透析(HD)和腹膜透析(PD)数据库登记的年龄≥18岁,透析时间≥3个月的患者,分析高钾血症发生率及其相关因素。 结果: 共纳入12 364例患者,男6 836例,年龄(51±15)岁,HD 4 230例,PD 8 134例,高钾血症发生率20.7%(2 554/12 364),低钾血症发生率17.0%(2 102/12 364)。多因素logistic回归分析结果显示,高钾血症的独立相关因素包括HD(OR=2.25,95%CI:1.54~3.30)、糖尿病(OR=1.65,95%CI:1.17~2.32)、高体质指数(BMI)(OR=1.06,95%CI:1.03~1.09)、高白蛋白(OR=1.04,95%CI:1.01~1.07)、高血磷(OR=3.12,95%CI:2.44~4.00)、低二氧化碳结合力(OR=0.89,95%CI:0.87~0.92)、低三酰甘油(OR=0.76,95%CI:0.68~0.85)、低血肌酐水平(OR=0.95,95%CI:0.90~0.99)、使用血管紧张素转化酶抑制剂/血管紧张素Ⅱ受体拮抗剂(ACEI/ARB)(OR=1.38,95%CI:1.11~1.72)及β-受体阻滞剂(OR=1.32,95%CI:1.07~1.64)。 结论: 我国透析患者高钾血症发生率为20.7%,HD、糖尿病、高BMI、高白蛋白、高血磷、低二氧化碳结合力、低三酰甘油、低血肌酐水平、使用ACEI/ARB及β-受体阻滞剂是其独立相关因素。.