Normal range of serum potassium, prevalence of dyskalaemia and associated factors in Chinese older adults: a cross-sectional study

Aoming Jin, Minghui Zhao, Yihong Sun, Xiangxian Feng, Ruijuan Zhang, Qianku Qiao, Hongxia Wang, Jianhui Yuan, Yuqi Wang, Lili Cheng, Hui Zhang, Hui-Juan Li, Yangfeng Wu, Aoming Jin, Minghui Zhao, Yihong Sun, Xiangxian Feng, Ruijuan Zhang, Qianku Qiao, Hongxia Wang, Jianhui Yuan, Yuqi Wang, Lili Cheng, Hui Zhang, Hui-Juan Li, Yangfeng Wu

Abstract

Objective: To investigate the normal range of serum potassium, the prevalence of dyskalaemia and the associated factors in Chinese older adults.

Design: A cross-sectional study conducted from September 2017 to March 2018.

Setting: Forty-eight community elderly care facilities in four regions in northern China.

Participants: A total of 1266 (308 apparently healthy and 958 unhealthy) participants 55 years or older and with fasting serum potassium measured.

Main outcome measures and methods: Serum potassium <3.5 mEq/L and >5.5 mEq/L (guidelines definition) and <2.5th and >97.5th percentiles of the distribution among healthy participants (our study definition) were both used to define hypokalaemia and hyperkalaemia, respectively. Multivariable generalised estimating equation models were used to adjust for clustering effect in the analyses of factors associated with risk of dyskalaemia and with variations in serum potassium.

Results: The study participants had a mean age of 70 (8.8) years. Among apparently healthy participants, the 2.5th and 97.5th percentiles of serum potassium distribution were 3.7 mEq/L and 5.3 mEq/L, respectively. Using the study definition, the prevalence of hyperkalaemia was 4.3% (95% CI 3.2% to 5.4%) and of hypokalaemia was 4.0% (95% CI 2.9% to 5.1%). Multivariable analyses showed that risk of hyperkalaemia was associated with unhealthy conditions (OR=2.21; 95% CI 1.17 to 4.18); risk of hypokalaemia was associated with unhealthy conditions (OR=2.56; 95% CI 1.05 to 6.23), older age (OR=1.70 per 10-year increase; 95% CI 1.04 to 2.79) and region (OR=16.87; 95% CI 6.41 to 44.38); and higher serum potassium was associated with male gender (mean difference (MD)=0.12; 95% CI 0.05 to 0.19) and estimated glomerular filtration rate <60 mL/min/1.73 m2 (MD=0.29; 95% CI 0.12 to 0.46). Using the guidelines definition, hyperkalaemia accounted for 2.7% (1.8%, 3.6%) and hypokalaemia 1.8% (1.1%, 2.5%). Analyses of the associated factors showed similar trends.

Conclusions: The study suggested a narrower normal range of serum potassium for defining dyskalaemia, which was common in older Chinese and more prevalent in unhealthy ones.

Trial registration number: NCT03290716; Pre-results.

Keywords: epidemiology; geriatric medicine; internal medicine.

Conflict of interest statement

Competing interests: YaW received a small research grant to evaluate the efficacy and safety of a novel salt substitute manufactured by the Health Source (Chongqing) Cardiovascular Health Technology.

© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Figures

Figure 1
Figure 1
Distribution of serum potassium in all, apparently healthy and unhealthy participants. Unhealthy conditions included hypertension, diabetes mellitus, coronary heart disease, stroke, chronic kidney disease, cancer, chronic obstructive pulmonary disease or being bedridden.

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