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Race, Serum Potassium, and Associations With ESRD and Mortality.

TitleRace, Serum Potassium, and Associations With ESRD and Mortality.
Publication TypeJournal Article
Year of Publication2017
AuthorsChen Y, Sang Y, Ballew SH, Tin A, Chang AR, Matsushita K, Coresh JJ, Kalantar-Zadeh K, Molnar MZ
Secondary AuthorsGrams ME
JournalAm J Kidney Dis
Volume70
Issue2
Pagination244-251
Date Published2017 Aug
ISSN1523-6838
KeywordsAfrican Americans, Continental Population Groups, Cross-Sectional Studies, Female, Humans, Kidney Failure, Chronic, Male, Middle Aged, Potassium, Prospective Studies
Abstract

BACKGROUND: Recent studies suggest that potassium levels may differ by race. The basis for these differences and whether associations between potassium levels and adverse outcomes differ by race are unknown.

STUDY DESIGN: Observational study.

SETTING & PARTICIPANTS: Associations between race and potassium level and the interaction of race and potassium level with outcomes were investigated in the Racial and Cardiovascular Risk Anomalies in Chronic Kidney Disease (RCAV) Study, a cohort of US veterans (N=2,662,462). Associations between African ancestry and potassium level were investigated in African Americans in the Atherosclerosis Risk in Communities (ARIC) Study (N=3,450).

PREDICTORS: Race (African American vs non-African American and percent African ancestry) for cross-sectional analysis; serum potassium level for longitudinal analysis.

OUTCOMES: Potassium level for cross-sectional analysis; mortality and end-stage renal disease for longitudinal analysis.

RESULTS: The RCAV cohort was 18% African American (N=470,985). Potassium levels on average were 0.162mmol/L lower in African Americans compared with non-African Americans, with differences persisting after adjustment for demographics, comorbid conditions, and potassium-altering medication use. In the ARIC Study, higher African ancestry was related to lower potassium levels (-0.027mmol/L per each 10% African ancestry). In both race groups, higher and lower potassium levels were associated with mortality. Compared to potassium level of 4.2mmol/L, mortality risk associated with lower potassium levels was lower in African Americans versus non-African Americans, whereas mortality risk associated with higher levels was slightly greater. Risk relationships between potassium and end-stage renal disease were weaker, with no difference by race.

LIMITATIONS: No data for potassium intake.

CONCLUSIONS: African Americans had slightly lower serum potassium levels than non-African Americans. Consistent associations between potassium levels and percent African ancestry may suggest a genetic component to these differences. Higher and lower serum potassium levels were associated with mortality in both racial groups.

DOI10.1053/j.ajkd.2017.01.044
Alternate JournalAm J Kidney Dis
PubMed ID28363732
PubMed Central IDPMC5526716
Grant ListHHSN268201100012C / HL / NHLBI NIH HHS / United States
HHSN268201100009I / HL / NHLBI NIH HHS / United States
HHSN268201100010C / HL / NHLBI NIH HHS / United States
UL1 RR025005 / RR / NCRR NIH HHS / United States
HHSN268201100008C / HL / NHLBI NIH HHS / United States
HHSN268201100005G / HL / NHLBI NIH HHS / United States
HHSN268201100008I / HL / NHLBI NIH HHS / United States
R01 HL059367 / HL / NHLBI NIH HHS / United States
HHSN268201100007C / HL / NHLBI NIH HHS / United States
K23 DK106515 / DK / NIDDK NIH HHS / United States
HHSN268201100011I / HL / NHLBI NIH HHS / United States
HHSN268201100011C / HL / NHLBI NIH HHS / United States
R01 HL086694 / HL / NHLBI NIH HHS / United States
U01 HG004402 / HG / NHGRI NIH HHS / United States
HHSN268201100006C / HL / NHLBI NIH HHS / United States
HHSN268201100005I / HL / NHLBI NIH HHS / United States
R01 DK108803 / DK / NIDDK NIH HHS / United States
HHSN268201100009C / HL / NHLBI NIH HHS / United States
HHSN268201100005C / HL / NHLBI NIH HHS / United States
HHSN268201100007I / HL / NHLBI NIH HHS / United States
K08 DK092287 / DK / NIDDK NIH HHS / United States
R01 HL087641 / HL / NHLBI NIH HHS / United States