Race, Serum Potassium, and Associations With ESRD and Mortality

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. Observational study. Associations between race and potassium level and the interaction of race and potas...

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Vydáno v:American journal of kidney diseases Ročník 70; číslo 2; s. 244
Hlavní autoři: Chen, Yan, Sang, Yingying, Ballew, Shoshana H, Tin, Adrienne, Chang, Alex R, Matsushita, Kunihiro, Coresh, Josef, Kalantar-Zadeh, Kamyar, Molnar, Miklos Z, Grams, Morgan E
Médium: Journal Article
Jazyk:angličtina
Vydáno: United States 01.08.2017
Témata:
African Americans
Continental Population Groups
Cross-Sectional Studies
Female
Humans
Kidney Failure, Chronic - blood
Kidney Failure, Chronic - mortality
Male
Middle Aged
Potassium - blood
Prospective Studies
African ancestry
hypokalemia
serum potassium
end-stage renal disease (ESRD)
Race
hyperkalemia
racial differences
mortality
kidney disease
genetic risk factor
African American
ISSN:1523-6838, 1523-6838
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Abstract 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. Observational study. 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). Race (African American vs non-African American and percent African ancestry) for cross-sectional analysis; serum potassium level for longitudinal analysis. Potassium level for cross-sectional analysis; mortality and end-stage renal disease for longitudinal analysis. 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. No data for potassium intake. 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.
AbstractList 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. Observational study. 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). Race (African American vs non-African American and percent African ancestry) for cross-sectional analysis; serum potassium level for longitudinal analysis. Potassium level for cross-sectional analysis; mortality and end-stage renal disease for longitudinal analysis. 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. No data for potassium intake. 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.
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.BACKGROUNDRecent 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.Observational study.STUDY DESIGNObservational study.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).SETTING & PARTICIPANTSAssociations 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).Race (African American vs non-African American and percent African ancestry) for cross-sectional analysis; serum potassium level for longitudinal analysis.PREDICTORSRace (African American vs non-African American and percent African ancestry) for cross-sectional analysis; serum potassium level for longitudinal analysis.Potassium level for cross-sectional analysis; mortality and end-stage renal disease for longitudinal analysis.OUTCOMESPotassium level for cross-sectional analysis; mortality and end-stage renal disease for longitudinal analysis.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.RESULTSThe 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.No data for potassium intake.LIMITATIONSNo data for potassium intake.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.CONCLUSIONSAfrican 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.
Author Chang, Alex R
Kalantar-Zadeh, Kamyar
Sang, Yingying
Coresh, Josef
Grams, Morgan E
Ballew, Shoshana H
Chen, Yan
Matsushita, Kunihiro
Molnar, Miklos Z
Tin, Adrienne
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  organization: Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
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  surname: Sang
  fullname: Sang, Yingying
  organization: Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
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  surname: Ballew
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  givenname: Miklos Z
  surname: Molnar
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  organization: Division of Nephrology, Department of Medicine, University of Tennessee Health Science Center, Memphis, TN; Department of Transplantation and Surgery, Semmelweis University, Budapest, Hungary
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  givenname: Morgan E
  surname: Grams
  fullname: Grams, Morgan E
  email: mgrams2@jhmi.edu
  organization: Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD; Division of Nephrology, Department of Medicine, Johns Hopkins University, Baltimore, MD. Electronic address: mgrams2@jhmi.edu
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Issue 2
Keywords African ancestry
hypokalemia
serum potassium
end-stage renal disease (ESRD)
Race
hyperkalemia
racial differences
mortality
kidney disease
genetic risk factor
African American
Language English
License Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.
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PublicationTitle American journal of kidney diseases
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Snippet Recent studies suggest that potassium levels may differ by race. The basis for these differences and whether associations between potassium levels and adverse...
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SubjectTerms African Americans
Continental Population Groups
Cross-Sectional Studies
Female
Humans
Kidney Failure, Chronic - blood
Kidney Failure, Chronic - mortality
Male
Middle Aged
Potassium - blood
Prospective Studies
Title Race, Serum Potassium, and Associations With ESRD and Mortality
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