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Gender-specific risk factors and outcomes of hyperkalemia in CKD patients: smoking as a driver of hyperkalemia in men

2023; Oxford University Press; Volume: 17; Issue: 1 Linguagem: Inglês

10.1093/ckj/sfad212

2048-8513

José Manuel Valdivielso, Sol Carriazo, Marisa Martín, Beatriz Fernández‐Fernández, Marcelino Bermúdez-López, Alberto Ortíz, A Provencio Regidor, Jaume Almirall, Esther Ponz, Arteaga Coloma, M. Auxiliadora Bajo, Díaz Ma Auxiliadora, Montserrat Belart Rodríguez, Antonio Gascón, Jordi Bover Sanjuán, Josep Bronsoms Artero, J.B. Cabezuelo, Salomé Muray Cases, Jesús Calviño Varela, Pilar Caro Acevedo, Jordi Carreras Bassa, Aleix Cases, Elisabet Massó Jiménez, Rosario Moreno López, Secundino Cigarrán, Saray López Prieto, Lourdes Comas Mongay, Isabel Comerma, Ma Teresa Compte Jové, Marta Cuberes Izquierdo, Fernando de Álvaro, Covadonga Hevia Ojanguren, Gabriel de Arriba, María Dolores del Pino y Pino, Rafael Diaz-Tejeiro Izquierdo, Marta Dotori, Verónica Duarte, Sara Estupiñan Torres, María José Fernández‐Reyes, Ma Loreto Fernández Rodríguez, Guillermina Fernández, Antonio Galán Serrano, César García Cantón, Antonio Luis García Herrera, Mercedes García Mena, Luis Gil Sacaluga, María Aguilar, José Luis Górriz, Emma Huarte Loza, José Luis Lerma, A. Cañada, Jesús Pedro Marín Álvarez, Nàdia Martín Alemany, Jesús Martín García, Alberto Martínez Castelao, María Martínez Villaescusa, Isabel Martínez, Itsaso Larrabide Eguren, Silvia Moreno Los Huertos, Ricardo Mouzo Mirco, Antonia Munar Vila, Ana Beatriz Muñoz Díaz, Juan F. Navarro‐González, Javier Nieto, Agustín Carreño, Enrique Novoa Fernández, Alberto Ortíz, Beatriz Fernández, Vicente Paraíso, Miguel Pérez Fontán, Ana Peris Domingo, Celestino Piñera Haces, Ma Dolores Prados Garrido, Mario Prieto Velasco, Carmina Puig Marí, Maite Rivera, Eduardo Rubio González, M. Pilar Ruiz, Mercedes Salgueira Lazo, Ana Isabel Martínez Puerto, José Antonio Sánchez Tomero, José Emilio Hernández Sánchez, Ramon Sans Lorman, Ramón Saracho, Maria‐Rosa Sarrias, Daniel Serón, María José Soler, Clara Barrios, Fernando Henrique Sousa, D Torán, Fernando Tornero Molina, José Javier Usón Carrasco, Ildefonso Valera Cortes, Ma Merce Vilaprinyo del Perugia, Rafael C Virto Ruiz,

Membrane-based Ion Separation Techniques

ABSTRACT Background Hyperkalemia is common among patients with chronic kidney disease (CKD) but there is scarce information on differential risk factors and outcomes for men and women. For instance, smoking has been suggested to be a risk factor for hyperkalemia, but specific analysis of the sex-specific impact of smoking on hyperkalemia in CKD is lacking. Methods We studied serum potassium levels in 2891 participants from the NEFRONA cohort: 483 controls (47% women) and 2408 CKD patients (38% women) without prior cardiovascular disease (CVD), assessing whether smoking is a risk factor for hyperkalemia, and if hyperkalemia is associated with outcomes separately for men and women. Results Median potassium levels and prevalence of hypo and hyperkalemia were higher in CKD participants than in controls. Serum potassium levels were higher and hyperkalemia and severe hyperkalemia more prevalent in men than in women with non-dialysis CKD (G3–G5). The highest prevalence of hyperkalemia for each gender was found in CKD G4-G5 and hemodialysis patients for men (46%) and in hemodialysis (54%) for women. Gender-specific etiological multivariate analysis identified current smoking as a risk factor for hyperkalemia only in men. Hyperkalemia was independently associated with stopping RAASi, an outcome which was more common in women. Hyperkalemia was also associated to higher risk of cardiovascular events within 4 years in men. In conclusion, hyperkalemia is common among men and women with CKD, but the prevalence, risk factors and outcomes may differ by gender. Specifically, current smoking is a driver of hyperkalemia in men.