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Potassium supplementation and long-term outcomes in chronic peritoneal dialysis patients with end-stage renal disease: a propensity score matching study

机译:慢性腹膜透析患者的钾补充剂和长期成果患者终末期肾病:倾向分数匹配研究

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Abstract Objective: In this retrospective matched-cohort study, the association between potassium supplementation and long-term outcomes was determined. Methods: Chronic peritoneal dialysis (PD) patients, aged ≥?16 years, being referred to four PD centers in China, with serum potassium levels ≤?3.5 mEq/L on three consecutive monthly in Q4 2008 and without receiving oral potassium supplementation in the prior three months were included in this study. Patients were divided into two groups, either to receive (test group) or not (control group) oral potassium supplementation in both Q4 2008 and the subsequent follow-up period, until 31 December 2014. The patients from the test group were matched to those from the control group using a propensity score. The clinical outcomes for all-cause and cardiovascular mortality were estimated by Matched Cox regression models during 61.5 months of median follow-up. All patients were also categorized according to serum potassium correction levels (p?=?0.38]. Cardiovascular mortality occurred in 97 patients (542/10,000 person-years) in the test group and 101 patients (598/10,000 person-years) in the control group (HR, 0.89; 95% CI, 0.67–1.18; p?=?0.43). There were no significant interactions between potassium supplementation and any of the subgroups, except for diabetes mellitus and volume overload. During a median follow-up of 61.5 months, adjusted all-cause mortality hazard ratio (HR) and 95% confidence interval (CI) for corrected serum potassium of <3.0, 3.0 to
机译:摘要目的:在这种回顾性匹配 - 队列研究中,确定了钾补充剂和长期结果之间的关联。方法:慢性腹膜透析(PD)患者,≥16岁,在中国的四个PD中心提到,血清钾水平≤1.35Meq/ L在2008年第四季度连续三月,不接受口服钾补充剂本研究中包括前三个月。患者分为两组,可在2008年第四季度和随后的后续期间接受(试验组)或不接受(对照组)口服钾补充剂,直到2014年12月31日。试验组的患者与那些相匹配从对照组使用倾向得分。在61.5个月的中位后续期间,通过匹配的Cox回归模型估算了全因和心血管死亡率的临床结果。所有患者也根据血清钾校正水平进行分类(P?= 0.38]。测试组中97名患者(542 / 10,000人)发生心血管死亡率,101名患者(598 / 10,000人 - 年)对照组(HR,0.89; 95%CI,0.67-1.18; p?= 0.43)。除糖尿病和体积过载外,钾补充剂和任何亚组之间没有显着的相互作用。在中位后续期间61.5个月,调整所有导致的死亡率危害比(HR)和95%置信区间(CI),用于校正血清钾的<3.0,3.0至<β.0,≥5.0Meq/ L,与4.0至<Δ5.0相比Meq / L(参考文献),分别为2.23(1.17-3.72),1.35(0.89-1.81)和1.74(1.05-3.72)。结论:慢性PD患者钾补充剂与死亡率无关。而逆向血症或维持正常血症可能需要进行矫正,并降低低钾血症 - 消失的死亡率。另外,可以优选使用醛固酮拮抗剂在PD患者中处理低钾血症。

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