Association of dietary potassium intake with the development of chronic kidney disease and renal function in patients with mildly decreased kidney function: The Korean multi-rural communities cohort study

Kwang Ho Mun, Gyeong Im Yu, Bo Youl Choi, Mi Kyung Kim, Min Ho Shin, Dong Hoon Shin

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Background: Dietary potassium has negative outcomes in patients with mildly impaired kidney function, while having positive outcomes in patients with hypertension. The association of dietary potassium intake with chronic kidney disease (CKD) development, with presence of hypertension, was studied in the Korean rural population with mildly impaired kidney function. Material/Methods: From 3 rural areas of Korea, 5064 participants age ≥40 with CKD stage 2 at baseline were recruited. Patients were classified according to the quartile of dietary potassium intake. Newly developed CKD, defined as estimated glomerular filtration rate (eGFR) of <60 mL/min/1.73 m 2 at the time of follow-up, and eGFR decline, defined as eGFR decrease >15% at follow-up, were studied. The effect of dietary potassium on CKD development and eGFR decline were studied by Cox proportional hazard models. The association of potassium with blood pressures and C-reactive protein was also studied to examine the underlying mechanisms. Results: Compared to 8.6% in normotensives, 15.7% of hypertensives developed CKD. The hazard ratio (HR) (95% confidence interval) of CKD was lower in high potassium diet only in hypertensives, with 0.60 (0.37-0.99) in the highest quartile. The eGFR decline was also lower in patients with higher potassium diet, with 0.70 (0.50–0.98) in Q3 and 0.54 (0.34–0.85) in Q4. Potassium intake has also been shown to decrease high diastolic blood pressure development (>90 mmHg) in hypertensives at 0.45 (0.25–0.83). Conclusions: Dietary potassium was associated with lower risk of CKD development and eGFR decline, and this association was observed only in hypertensives.

Original languageEnglish
Pages (from-to)1061-1070
Number of pages10
JournalMedical Science Monitor
Volume25
DOIs
StatePublished - 2019 Jan 1

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Dietary Potassium
Rural Population
Chronic Renal Insufficiency
Glomerular Filtration Rate
Cohort Studies
Kidney
Potassium
Hypertension
Diet
Blood Pressure
Korea
Proportional Hazards Models
C-Reactive Protein
Confidence Intervals

Keywords

  • Chronic
  • Cohort studies
  • Dietary
  • Kidney failure
  • Potassium

Cite this

@article{a4f5ecd141484db5b3549068cde8a28b,
title = "Association of dietary potassium intake with the development of chronic kidney disease and renal function in patients with mildly decreased kidney function: The Korean multi-rural communities cohort study",
abstract = "Background: Dietary potassium has negative outcomes in patients with mildly impaired kidney function, while having positive outcomes in patients with hypertension. The association of dietary potassium intake with chronic kidney disease (CKD) development, with presence of hypertension, was studied in the Korean rural population with mildly impaired kidney function. Material/Methods: From 3 rural areas of Korea, 5064 participants age ≥40 with CKD stage 2 at baseline were recruited. Patients were classified according to the quartile of dietary potassium intake. Newly developed CKD, defined as estimated glomerular filtration rate (eGFR) of <60 mL/min/1.73 m 2 at the time of follow-up, and eGFR decline, defined as eGFR decrease >15{\%} at follow-up, were studied. The effect of dietary potassium on CKD development and eGFR decline were studied by Cox proportional hazard models. The association of potassium with blood pressures and C-reactive protein was also studied to examine the underlying mechanisms. Results: Compared to 8.6{\%} in normotensives, 15.7{\%} of hypertensives developed CKD. The hazard ratio (HR) (95{\%} confidence interval) of CKD was lower in high potassium diet only in hypertensives, with 0.60 (0.37-0.99) in the highest quartile. The eGFR decline was also lower in patients with higher potassium diet, with 0.70 (0.50–0.98) in Q3 and 0.54 (0.34–0.85) in Q4. Potassium intake has also been shown to decrease high diastolic blood pressure development (>90 mmHg) in hypertensives at 0.45 (0.25–0.83). Conclusions: Dietary potassium was associated with lower risk of CKD development and eGFR decline, and this association was observed only in hypertensives.",
keywords = "Chronic, Cohort studies, Dietary, Kidney failure, Potassium",
author = "Mun, {Kwang Ho} and Yu, {Gyeong Im} and Choi, {Bo Youl} and Kim, {Mi Kyung} and Shin, {Min Ho} and Shin, {Dong Hoon}",
year = "2019",
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day = "1",
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language = "English",
volume = "25",
pages = "1061--1070",
journal = "Medical science monitor : international medical journal of experimental and clinical research",
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Association of dietary potassium intake with the development of chronic kidney disease and renal function in patients with mildly decreased kidney function : The Korean multi-rural communities cohort study. / Mun, Kwang Ho; Yu, Gyeong Im; Choi, Bo Youl; Kim, Mi Kyung; Shin, Min Ho; Shin, Dong Hoon.

In: Medical Science Monitor, Vol. 25, 01.01.2019, p. 1061-1070.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Association of dietary potassium intake with the development of chronic kidney disease and renal function in patients with mildly decreased kidney function

T2 - The Korean multi-rural communities cohort study

AU - Mun, Kwang Ho

AU - Yu, Gyeong Im

AU - Choi, Bo Youl

AU - Kim, Mi Kyung

AU - Shin, Min Ho

AU - Shin, Dong Hoon

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: Dietary potassium has negative outcomes in patients with mildly impaired kidney function, while having positive outcomes in patients with hypertension. The association of dietary potassium intake with chronic kidney disease (CKD) development, with presence of hypertension, was studied in the Korean rural population with mildly impaired kidney function. Material/Methods: From 3 rural areas of Korea, 5064 participants age ≥40 with CKD stage 2 at baseline were recruited. Patients were classified according to the quartile of dietary potassium intake. Newly developed CKD, defined as estimated glomerular filtration rate (eGFR) of <60 mL/min/1.73 m 2 at the time of follow-up, and eGFR decline, defined as eGFR decrease >15% at follow-up, were studied. The effect of dietary potassium on CKD development and eGFR decline were studied by Cox proportional hazard models. The association of potassium with blood pressures and C-reactive protein was also studied to examine the underlying mechanisms. Results: Compared to 8.6% in normotensives, 15.7% of hypertensives developed CKD. The hazard ratio (HR) (95% confidence interval) of CKD was lower in high potassium diet only in hypertensives, with 0.60 (0.37-0.99) in the highest quartile. The eGFR decline was also lower in patients with higher potassium diet, with 0.70 (0.50–0.98) in Q3 and 0.54 (0.34–0.85) in Q4. Potassium intake has also been shown to decrease high diastolic blood pressure development (>90 mmHg) in hypertensives at 0.45 (0.25–0.83). Conclusions: Dietary potassium was associated with lower risk of CKD development and eGFR decline, and this association was observed only in hypertensives.

AB - Background: Dietary potassium has negative outcomes in patients with mildly impaired kidney function, while having positive outcomes in patients with hypertension. The association of dietary potassium intake with chronic kidney disease (CKD) development, with presence of hypertension, was studied in the Korean rural population with mildly impaired kidney function. Material/Methods: From 3 rural areas of Korea, 5064 participants age ≥40 with CKD stage 2 at baseline were recruited. Patients were classified according to the quartile of dietary potassium intake. Newly developed CKD, defined as estimated glomerular filtration rate (eGFR) of <60 mL/min/1.73 m 2 at the time of follow-up, and eGFR decline, defined as eGFR decrease >15% at follow-up, were studied. The effect of dietary potassium on CKD development and eGFR decline were studied by Cox proportional hazard models. The association of potassium with blood pressures and C-reactive protein was also studied to examine the underlying mechanisms. Results: Compared to 8.6% in normotensives, 15.7% of hypertensives developed CKD. The hazard ratio (HR) (95% confidence interval) of CKD was lower in high potassium diet only in hypertensives, with 0.60 (0.37-0.99) in the highest quartile. The eGFR decline was also lower in patients with higher potassium diet, with 0.70 (0.50–0.98) in Q3 and 0.54 (0.34–0.85) in Q4. Potassium intake has also been shown to decrease high diastolic blood pressure development (>90 mmHg) in hypertensives at 0.45 (0.25–0.83). Conclusions: Dietary potassium was associated with lower risk of CKD development and eGFR decline, and this association was observed only in hypertensives.

KW - Chronic

KW - Cohort studies

KW - Dietary

KW - Kidney failure

KW - Potassium

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U2 - 10.12659/MSM.913504

DO - 10.12659/MSM.913504

M3 - Article

VL - 25

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SN - 1234-1010

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