Analysis of prevalence and influencing factors of hyperkalemia among people in elderly care institutions in southeastern Shanxi
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摘要:
目的 了解山西省东南部地区机构养老人群高钾血症的患病率及影响因素。 方法 采用随机整群抽样方法于2017年9―11月选取山西省东南部地区16家养老机构人群进行问卷调查，并采集外周血进行实验室检查。采用logistic回归分析模型分析高钾血症的影响因素。 结果 共纳入研究对象523人，平均年龄为(66.20±8.61)岁；平均血钾浓度为(4.50±0.45)mmol/L，高钾血症(血钾>5.0 mmol/L)患病率为13.95%(95% CI: 11.02%~16.93%)。Logistic回归分析模型分析结果显示随着肾小球滤过率(estimated glomerular filtration rate, eGFR)的降低，高钾血症发生风险升高(χ2 =8.189, P=0.017)，与eGFR>90 mL/(min·1.73m2)相比，60~90 mL/(min·1.73m2)与 < 60 mL/(min·1.73m2)高钾血症发生风险分别为4.11倍(OR=4.11, 95% CI：1.06~16.01, P=0.042)和6.04倍(OR=6.04, 95% CI：1.64~22.17, P=0.007)。 结论 山西省东南部地区机构养老人群中高钾血症患病率较高，eGFR低水平为高钾血症发生的危险因素。 Abstract:Objective To examine the prevalence and factors associated with hyperkalemia among the elderly residing in care facilities in the southeastern area of Shanxi province. Methods A questionnaire survey was carried out on individuals from 16 care institutions in the southeastern province of Shanxi between September and November, 2017. A random cluster sampling method was employed to select subjects. In addition, peripheral blood samples were collected for laboratory examination. The analysis of hyperkalemia was conducted using logistic regression to determine the contributing factors. Results A total of 523 individuals were included in this study [average age: (66.20±8.61) years old], and the average serum potassium concentration was (4.50±0.45)mmol/L. The prevalence of hyperkalemia (>5.0 mmol/L) was 13.95% (95% CI: 11.02%-16.93%). Logistic regression analysis showed that the risk of hyperkalemia increased with a decreasing estimated glomerular filtration rate(eGFR) (χ2 =8.189, P=0.017). Compared with eGFR>90 mL/(min·1.73m2), the risk of hyperkalemia was 4.11 times with eGFR 60-90 mL/(min·1.73m2) (OR=4.11, 95% CI: 1.06-16.01, P=0.042) and 6.04 times with eGFR < 60 mL/(min·1.73m2) (OR=6.04, 95% CI: 1.64-22.17, P=0.007). Conclusions The prevalence of hyperkalemia is higher in the institutionalized elderly population, and the lower level of eGFR is a risk factor for hyperkalemia. -
Key words:
- Hyperkalemia /
- Morbidity rate /
- Influencing factors
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表 1 不同血钾水平下相关指标比较
Table 1. Comparison of related indicators under different serum potassium levels
变量Variable 血钾 ① Serum potassium ①
>5.0 mmol/L
(n=73)血钾 ① Serum potassium ①
≤5.0 mmol/L
(n=450)Z/χ2值
valueP值
value年龄/岁Age /years 66.00(61.00, 73.00) 66.00(61.00, 72.00) -0.020 0.984 男性Men 69.00(94.52) 418.00(92.89) 0.261 0.610 BMI/(kg·m-2) 23.53(20.79, 26.94) 23.91(21.79, 26.40) -0.377 0.706 收缩压Systolic blood pressure/mmHg 132.33(118.83, 146.67) 137.50(122.92, 149.08) -1.207 0.227 舒张压Diastolic blood pressure/mmHg 82.33(73.67, 88.17) 82.33(74.67, 90.00) -0.987 0.323 吸烟Smoking 33.00(45.21) 208.00(46.22) 0.026 0.872 饮酒Drinking 8.00(10.96) 65.00(14.44) 0.635 0.425 不健康状况Unhealthy conditions 40.00(54.79) 264.00(58.67) 0.387 0.534 高血压Hypertension 43.00(58.90) 297.00(66.00) 1.390 0.238 脑卒中Stroke 19.00(26.03) 112.00(24.89) 0.043 0.835 糖尿病Diabetes mellitus 5.00(6.85) 18.00(4.00) 0.630 0.427 冠状动脉粥样硬化性心脏病Coronary atherosclerotic heart disease 14.00(19.18) 44.00(9.78) 5.629 0.018 慢性肾病Chronic kidney disease 3.00(4.11) 18.00(4.00) 0.000 1.000 COPD 1.00(1.37) 8.00(1.78) 0.000 1.000 恶性肿瘤Cancer 2.00(2.74) 5.00(1.11) 0.348 0.555 服用降压药Antihypertension medication use 27.00(36.99) 200.00(44.44) 1.422 0.233 血管紧张素转化酶抑制剂/血管紧张素Ⅱ受体拮抗剂
Angiotensin converting enzyme inhibitor/Angiotensin receptor blocker6.00(8.22) 45.00(10.00) 0.226 0.634 利尿剂Diuretic 4.00(5.48) 32.00(7.11) 0.261 0.610 β受体阻滞剂β blocker 3.00(4.11) 8.00(1.78) 0.719 0.396 钙通道阻滞剂Calcium channel blocker 23.00(31.51) 160.00(35.56) 0.453 0.501 血钠/(mmol·L-1) Serum sodium/(mmol·L-1) 142.00(141.00, 144.00) 143.00(141.00, 144.00) -0.985 0.325 血肌酐/(μmol·L-1) Serum creatinine/(μmol·L-1) 70.00(59.00, 85.00) 66.00(60.00, 75.00) -1.804 0.071 总胆固醇/(mmol·L-1) Total Cholesterol/(mmol·L-1) 4.53(2.87, 5.07) 4.27(3.82, 5.01) -1.219 0.223 三酰甘油/(mmol·L-1) Triglyceride/(mmol·L-1) 1.35(0.97, 1.77) 1.23(0.89, 1.69) -1.330 0.183 高密度脂蛋白/(mmol·L-1) High-density lipoprotein/(mmol·L-1) 1.08(0.97, 1.26) 1.07(0.95, 1.23) -0.229 0.819 低密度脂蛋白/(mmol·L-1) Low-density lipoprotein/(mmol·L-1) 2.70(2.25, 3.19) 2.54(2.16, 3.07) -1.202 0.229 空腹血糖/(mmol·L-1) Fasting plasma glucose/(mmol·L-1) 5.07(4.84, 5.49) 5.01(4.72, 5.47) -1.391 0.164 eGFR/[mL·min-1·(1.73m2)-1] 100.00(79.00, 105.50) 102.00(92.00, 111.00) -2.717 0.007 注：eGFR, 估计的肾小球滤过率; COPD, 慢性阻塞性肺疾病。
①以人数(占比/%)或M(P25，P75)表示。
Note: eGFR, estimated glomerular filtration rate; COPD, chronic obstructive pulmonary disease.
① Number of people(proportion/%) or M(P25，P75).
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表 2 高钾血症影响因素logistic回归分析结果
Table 2. Results of logistic regression analysis of influencing factors of hyperkalemia
变量Variables β值
valuesx Wald χ2值
valueOR值value
(95% CI)P值
value冠状动脉粥样硬化性心脏病Coronary atherosclerotic heart disease 0.623 0.350 3.166 1.87(0.94~3.70) 0.075 eGFR/[mL·min-1·(1.73m2)-1] >90 1.00 60~90 1.414 0.694 4.154 4.11(1.06~16.01) 0.042 < 60 1.798 0.664 7.332 6.04(1.64~22.17) 0.007 常数项Constant -0.375 0.674 0.309 0.69 0.578 注：eGFR, 估计的肾小球滤过率。
Note: eGFR, estimated glomerular filtration rate.
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