HYPOKALAEMIA AND PERITONEAL DIALYSIS- RELATED PERITONITIS: ASSOCIATION, RISK FACTORS AND OUTCOMES
Dr Shabana kalla1,2, Prof David Johnson1,2, Dr Christine Chang1, Marguerite Conley1, Lauren Jaffrey1, Prof Carmel Hawley1,2, Dr Carolyn van Eps1,2, Associate Prof Yeoungjee Cho1,2
1Princess Alexandra Hospital, Queensland Health, Brisbane , Australia, 2Faculty of Medicine, The University of Queensland, Brisbane, Australia
Aim: This single centre retrospective observational study was conducted to examine the association between hypokalaemia and the risk of peritonitis in an Australian cohort.
Background: Peritonitis is a serious complication associated with risk of death and transfer to haemodialysis for patients receiving peritoneal dialysis (PD). To mitigate such risk, it is important to identify potential reversible risk factors such as hypokalaemia.
Method: Patients who started PD at the Princess Alexandra Hospital, Australia from 1st January 2013 to 31st December 2022 were included. Hypokalaemia, defined as serum potassium less than 3.5mmol/L, was assessed at the time of PD initiation and evaluated as categories based on 6-month average after PD commencement (< 3.5mmol/L, 3.5-4.5mmol/L and > 4.5mmol/L). Time to first peritonitis was examined using multivariable Cox survival analyses censored for transplantation, recovery of kidney function or loss to follow up.
Results: In total, 486 patients were included, of whom 23 patients (4.7%) recorded a baseline serum potassium< 3.5 mmol/L, 212 patients (44%) with 3.5-4.5 mmol/L and 251 patients (52%) with >4.5mmol/L. During the study period, 192 patients experienced peritonitis with comparable proportions across all three groups (<3.5mmol/L – 35%, 3.5-4.5mmol/L – 40% and >4.5mmol/L – 40%). Using multivariable regression modelling, time to first peritonitis was not significantly associated with baseline hypokalaemia (hazard ratio 0.66, 95% confidence interval 0.32-1.40) or hypokalaemia based on 6-month average (hazard ratio 1.14, 95% Confidence interval 0.63-2.05).
Conclusion: In this study, there was no association between hypokalaemia and risk of peritonitis. However, the strength of the findings was limited by small sample size. Further studies in larger population are needed to consider the role of hypokalaemia in the risk of peritonitis.
Biography:
Shabana is a final year renal advanced trainee. She has a keen interest in peritoneal dialysis, glomerular diseases and kidney supportive care.