American Journal of Kidney Diseases
Volume 56, Issue 2 , Pages 338-347 , August 2010

Dietary Potassium Intake and Mortality in Long-term Hemodialysis Patients

  • Nazanin Noori, MD, PhD

      Affiliations

    • Harold Simmons Center for Chronic Disease Research and Epidemiology, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA
    • Division of Nephrology and Hypertension, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA
  • ,
  • Kamyar Kalantar-Zadeh, MD, MPH, PhD

      Affiliations

    • Harold Simmons Center for Chronic Disease Research and Epidemiology, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA
    • Division of Nephrology and Hypertension, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA
    • David Geffen School of Medicine at UCLA and UCLA School of Public Health, Los Angeles, CA
    • Corresponding Author InformationAddress correspondence to Kamyar Kalantar-Zadeh, MD, MPH, PhD, Harold Simmons Center for Chronic Disease Research and Epidemiology, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, 1124 West Carson St, C1-Annex, Torrance, CA 90502
  • ,
  • Csaba P. Kovesdy, MD

      Affiliations

    • Salem Veterans Affairs Medical Center, Salem, VA
  • ,
  • Sameer B. Murali, MD

      Affiliations

    • Harold Simmons Center for Chronic Disease Research and Epidemiology, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA
  • ,
  • Rachelle Bross, RD, PhD

      Affiliations

    • Division of Nephrology and Hypertension, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA
  • ,
  • Allen R. Nissenson, MD

      Affiliations

    • David Geffen School of Medicine at UCLA and UCLA School of Public Health, Los Angeles, CA
    • DaVita Inc, Lakewood, CO
  • ,
  • Joel D. Kopple, MD

      Affiliations

    • Harold Simmons Center for Chronic Disease Research and Epidemiology, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA
    • Division of Nephrology and Hypertension, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA
    • David Geffen School of Medicine at UCLA and UCLA School of Public Health, Los Angeles, CA

Received 11 November 2009 ,Accepted 3 March 2010.

References 

  1. Port FK. Morbidity and mortality in dialysis patients. Kidney Int. 1994;46:1728–1737
  2. Iseki K, Kawazoe N, Osawa A, Fukiyama K. Survival analysis of dialysis patients in Okinawa, Japan (1971-1990). Kidney Int. 1993;43:404–409
  3. Berl T, Henrich W. Kidney-heart interactions: epidemiology, pathogenesis, and treatment. Clin J Am Soc Nephrol. 2006;1:8–18
  4. Go AS, Chertow GM, Fan D, McCulloch CE, Hsu CY. Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. N Engl J Med. 2004;351:1296–1305
  5. Lowrie EG, Lew NL. Death risk in hemodialysis patients: the predictive value of commonly measured variables and an evaluation of death rate differences between facilities. Am J Kidney Dis. 1990;15:458–482
  6. Iseki K, Uehara H, Nishime K, et al. Impact of the initial levels of laboratory variables on survival in chronic dialysis patients. Am J Kidney Dis. 1996;28:541–548
  7. Gonick HC, Kleeman CR, Rubini ME, Maxwell MH. Functional impairment in chronic renal disease (3. Studies of potassium excretion). Am J Med Sci. 1971;261:281–290
  8. Hayes CP, Robinson RR. Fecal potassium excretion in patients on chronic intermittent hemodialysis. Trans Am Soc Artif Intern Organs. 1965;11:242–246
  9. Hayes CP, McLeod ME, Robinson RR. An extravenal mechanism for the maintenance of potassium balance in severe chronic renal failure. Trans Assoc Am Physicians. 1967;80:207–216
  10. Kopple JD, Coburn JW. Metabolic studies of low protein diets in uremia (I. Nitrogen and potassium). Medicine (Baltimore). 1973;52:583–595
  11. Schrier RW, Regal EM. Influence of aldosterone on sodium, water and potassium metabolism in chronic renal disease. Kidney Int. 1972;1:156–168
  12. Kovesdy CP, Regidor DL, Mehrotra R, et al. Serum and dialysate potassium concentrations and survival in hemodialysis patients. Clin J Am Soc Nephrol. 2007;2:999–1007
  13. Unruh ML, Evans IV, Fink NE, Powe NR, Meyer KB. Skipped treatments, markers of nutritional nonadherence, and survival among incident hemodialysis patients. Am J Kidney Dis. 2005;46:1107–1116
  14. Kidney disease. www.uptodate.comAccessed April 2, 2010
  15. Bross R, Zitterkoph J, Pithia J, et al. Association of serum total iron-binding capacity and its changes over time with nutritional and clinical outcomes in hemodialysis patients. Am J Nephrol. 2009;29:571–581
  16. Colman S, Bross R, Benner D, et al. The Nutritional and Inflammatory Evaluation in Dialysis Patients (NIED) Study: overview of the NIED Study and the role of dietitians. J Ren Nutr. 2005;15:231–243
  17. Rambod M, Kovesdy CP, Kalantar-Zadeh K. Malnutrition-inflammation score for risk stratification of patients with CKD: is it the promised gold standard?. Nat Clin Pract Nephrol. 2008;4:354–355
  18. Rambod M, Bross R, Zitterkoph J, et al. Association of malnutrition-inflammation score with quality of life and mortality in hemodialysis patients: a 5-year prospective cohort study. Am J Kidney Dis. 2009;53:298–309
  19. Shantouf R, Kovesdy CP, Kim Y, et al. Association of serum alkaline phosphatase with coronary artery calcification in maintenance hemodialysis patients. Clin J Am Soc Nephrol. 2009;4:1106–1114
  20. Mehrotra R, Kermah D, Fried L, et al. Chronic peritoneal dialysis in the United States: declining utilization despite improving outcomes. J Am Soc Nephrol. 2007;18:2781–2788
  21. Beddhu S, Bruns FJ, Saul M, Seddon P, Zeidel ML. A simple comorbidity scale predicts clinical outcomes and costs in dialysis patients. Am J Med. 2000;108:609–613
  22. Nelson EE, Hong CD, Pesc ALPetersonDW, Singh S, Pollak VE. Anthropometric norms for the dialysis population. Am J Kidney Dis. 1990;16:32–37
  23. Williams AJ, McArley A. Body composition, treatment time, and outcome in hemodialysis patients. J Ren Nutr. 1999;9:157–162
  24. Kalantar-Zadeh K, Dunne E, Nixon K, et al. Near infra-red interactance for nutritional assessment of dialysis patients. Nephrol Dial Transplant. 1999;14:169–175
  25. Kalantar-Zadeh K, Kuwae N, Wu DY, et al. Associations of body fat and its changes over time with quality of life and prospective mortality in hemodialysis patients. Am J Clin Nutr. 2006;83:202–210
  26. Ridker PM, Rifai N, Rose L, Buring JE, Cook NR. Comparison of C-reactive protein and low-density lipoprotein cholesterol levels in the prediction of first cardiovascular events. N Engl J Med. 2002;347:1557–1565
  27. Erbagci AB, Tarakcioglu M, Aksoy M, et al. Diagnostic value of CRP and Lp(a) in coronary heart disease. Acta Cardiol. 2002;57:197–204
  28. Pecoits-Filho R, Barany P, Lindholm B, Heimburger O, Stenvinkel P. Interleukin-6 is an independent predictor of mortality in patients starting dialysis treatment. Nephrol Dial Transplant. 2002;17:1684–1688
  29. Beutler B, Cerami A. The biology of cachectin/TNF—a primary mediator of the host response. Annu Rev Immunol. 1989;7:625–655
  30. Block G, Thompson FE, Hartman AM, Larkin FA, Guire KE. Comparison of two dietary questionnaires validated against multiple dietary records collected during a 1-year period. J Am Diet Assoc. 1992;92:686–693
  31. Block G, Woods M, Potosky A, Clifford C. Validation of a self-administered diet history questionnaire using multiple diet records. J Clin Epidemiol. 1990;43:1327–1335
  32. Klein RF, Friedman-Campbell M, Tocco RV. History taking and substance abuse counseling with the pregnant patient. Clin Obstet Gynecol. 1993;36:338–346
  33. Block G, Hartman AM, Naughton D. A reduced dietary questionnaire: development and validation. Epidemiology. 1990;1:58–64
  34. Block G, Wakimoto P, Jensen C, Mandel S, Green RR. Validation of a food frequency questionnaire for Hispanics [abstract]. Prev Chronic Dis. 2006;3:77A
  35. Day N, McKeown N, Wong M, Welch A, Bingham S. Epidemiological assessment of diet: a comparison of a 7-day diary with a food frequency questionnaire using urinary markers of nitrogen, potassium and sodium. Int J Epidemiol. 2001;30:309–317
  36. Noori N, Kalantar-Zadeh K, Kovesdy CP, Bross R, Benner D, Kopple JD. Association of dietary phosphorus intake and phosphorus to protein ratio with mortality in hemodialysis patients. Clin J Am Soc Nephrol. 2010;5:683–692
  37. Durrleman S, Simon R. Flexible regression models with cubic splines. Stat Med. 1989;8:551–561
  38. Saran R, Bragg-Gresham JL, Rayner HC, et al. Nonadherence in hemodialysis: associations with mortality, hospitalization, and practice patterns in the DOPPS. Kidney Int. 2003;64:254–262
  39. Kalantar-Zadeh K, Kopple JD, Deepak S, Block D, Block G. Food intake characteristics of hemodialysis patients as obtained by food frequency questionnaire. J Ren Nutr. 2002;12:17–31
  40. Kooienga L. Phosphorus balance with daily dialysis. Semin Dial. 2007;20:342–345
  41. Kaveh K, Kimmel PL. Compliance in hemodialysis patients: multidimensional measures in search of a gold standard. Am J Kidney Dis. 2001;37:244–266
  42. Wolcott DL, Maida CA, Diamond R, Nissenson AR. Treatment compliance in end-stage renal disease patients on dialysis. Am J Nephrol. 1986;6:329–338
  43. Foley RN, Parfrey PS, Hefferton D, Singh I, Simms A, Barrett BJ. Advance prediction of early death in patients starting maintenance dialysis. Am J Kidney Dis. 1994;23:836–845
  44. Delmez JA, Slatopolsky E. Hyperphosphatemia: its consequences and treatment in patients with chronic renal disease. Am J Kidney Dis. 1992;19:303–317
  45. Kloppenburg WD, Stegeman CA, Hooyschuur M, van der Ven J, de Jong PE, Huisman RM. Assessing dialysis adequacy and dietary intake in the individual hemodialysis patient. Kidney Int. 1999;55:1961–1969
  46. Brunner E, Stallone D, Juneja M, Bingham S, Marmot M. Dietary assessment in Whitehall II: comparison of 7 d diet diary and food-frequency questionnaire and validity against biomarkers. Br J Nutr. 2001;86:405–414

 Originally published online as doi:10.1053/j.ajkd.2010.03.022 on June 28, 2010.

PII: S0272-6386(10)00730-4

doi: 10.1053/j.ajkd.2010.03.022

American Journal of Kidney Diseases
Volume 56, Issue 2 , Pages 338-347 , August 2010