Factors associated with kalemia in renal disease.

Abstract

International recommendations promote a strict potassium diet in order to avoid hyperkalemia in chronic kidney disease (CKD) patients. However, the efficiency of such a dietary recommendation has never been demonstrated. The objectives of this study were to define the relationship between kalemia, dietary potassium intake estimated by kaliuresis and renal function, and to define the factors associated with kalemia in patients using artificial intelligence. To this extent, data from patients followed in a nephrology unit, included in the UniverSel study and whose kalemia (measured on the day of urine collection; n=367) were analyzed. The patients included had a wide range of estimated glomerular filtration rate (eGFR), but few had stage 5 CKD. Kalemia was negatively and linearly correlated to eGFR (P<.001) but was not correlated to kaliuresis (P=.55). Kaliuresis was not correlated to eGFR (P=.08). Factors associated with kalemia were analyzed using a Bayesian network. The five variables most associated with kalemia were, in descending order, eGFR, original nephropathy, age, diabetes and plasma bicarbonate level. The results of this study do not support a strict dietary potassium control to regulate kalemia in stage 1-4 CKD patients.