Background: The association between potassium (sK) level trajectory and mortality or the need for kidney replacement therapy (KRT) during acute kidney injury (AKI) has not been adequately explored. Methods: In this prospective cohort, AKI patients admitted to the Hospital Civil de Guadalajara were enrolled. Eight groups based on the sK (mEq/L) level trajectories during 10 days of hospitalization were created, (1) normokalemia (normoK), defined as sK between 3.5-5.5; (2) hyperkalemia to normoK; (3) hypokalemia to normoK; (4) fluctuating potassium; (5) persistent hypoK; (6) normoK to hypoK; (7) normoK to hyperK; (8) persistent hyperK. We assessed the association of sK trajectories with mortality and the need for KRT. Results: A total of 311 AKI patients were included. The mean age 52.6 years, and 58.6% were male. AKI stage 3 was present in 63.9%. KRT started in 36% patients, and 21.2% died. After adjusting for confounders, 10-day hospital mortality was significantly higher in group 7 and 8 (OR, 1.35 and 1.61, p = <0.05, for both, respectively), and KRT initiation was higher only in group 8 (OR 1.38, p = < 0.05) compared with group 1. Mortality in different subgroups of patients in group 8 did not change the primary results. Conclusion: In our prospective cohort, most patients with AKI had alterations in sK+. NormoK to hyperK and persistent hyperK were associated with death, while only persistent hyperK was correlated with the need for KRT.

Background: Kidneys play a primary role in potassium homeostasis. The association between potassium (sK+) level and mortality or the need for kidney replacement therapy (KRT) during acute kidney injury (AKI) has not been adequately explored. Methods: In this prospective cohort study, AKI patients admitted to the Hospital Civil de Guadalajara were enrolled from August 2017 to June 2021 with AKI. We divided patients into 8 groups based on the serum potassium level trajectories up to ten days following hospitalization, (1) normokalemia (normoK), defined as sK+ values between 3.5 and 5.5 mEq/L; (2) corrected hyperkalemia (hyperK), sK+ > 5.5 mEq/L on hospital admission and decreased to normoK; (3) corrected hypokalemia (hypoK), sK+ < 3.5 mEq/L on hospital admission and increased to normoK; (4) fluctuating potassium, sK+ increased / decreased in and out of normoK parameters; (5) uncorrected hypoK, sK+ < 3.5 mEq/L; (6) normoK to hypoK, sK+ that were normal on hospital admission and decreased to hypoK and never went back to normal; (7) normoK to hyperK, sK+ that were normal on hospital admission and increased to hyperK and never went back to normal; (8) uncorrected hyperK, sK+ > 5.5 mEq/L. We assessed the association of serum potassium trajectories with mortality and the need for KRT (secondary objective). Results: A total of 311 AKI patients were included. The mean age was 52.6 years, and 182 (58.6%) were male. AKI stage 3 was present in 199 (63.9%). KRT started in 112 (36%) patients, and 66 (21.2%) died. After adjusting for confounders, 10-day hospital mortality was significantly higher in group 7 and 8 (OR, 1.37 and 1.63, p = <0.05, for both, respectevely), and KRT initiation was higher only in group 8 (OR 1.40, p = < 0.05) compared with group 1. Mortality in different subgroups of patients in group 8 did not change the primary results.Conclusion: In our prospective cohort, most patients with AKI had alterations in sK+. NormoK to hyperK and Uncorrected hyperK were associated with death, while only uncorrected hyperK was correlated with the need for KRT.

Background: Kidneys play a primary role in potassium homeostasis. The association between potassium (sK+) level and mortality or the need for kidney replacement therapy (KRT) during acute kidney injury (AKI) has not been adequately explored. Methods: In this prospective cohort study, AKI patients admitted to the Hospital Civil de Guadalajara were enrolled from August 2017 to June 2021 with AKI. We divided patients into 8 groups based on the serum potassium level trajectories up to ten days following hospitalization, (1) normokalemia (normoK), defined as sK+ values between 3.5 and 5.5 mEq/L; (2) corrected hyperkalemia (hyperK), sK+ > 5.5 mEq/L on hospital admission and decreased to normoK; (3) corrected hypokalemia (hypoK), sK+ < 3.5 mEq/L on hospital admission and increased to normoK; (4) fluctuating potassium, sK+ increased / decreased in and out of normoK parameters; (5) uncorrected hypoK, sK+ < 3.5 mEq/L; (6) normoK to hypoK, sK+ that were normal on hospital admission and decreased to hypoK and never went back to normal; (7) normoK to hyperK, sK+ that were normal on hospital admission and increased to hyperK and never went back to normal; (8) uncorrected hyperK, sK+ > 5.5 mEq/L. We assessed the association of serum potassium trajectories with mortality and the need for KRT (secondary objective). Results: A total of 311 AKI patients were included. The mean age was 52.6 years, and 182 (58.6%) were male. AKI stage 3 was present in 199 (63.9%). KRT started in 112 (36%) patients, and 66 (21.2%) died. After adjusting for confounders, 10-day hospital mortality was significantly higher in group 7 and 8 (OR, 1.37 and 1.63, p = <0.05, for both, respectevely), and KRT initiation was higher only in group 8 (OR 1.40, p = < 0.05) compared with group 1. Mortality in different subgroups of patients in group 8 did not change the primary results.Conclusion: In our prospective cohort, most patients with AKI had alterations in sK+. NormoK to hyperK and Uncorrected hyperK were associated with death, while only uncorrected hyperK was correlated with the need for KRT.

Background: Kidneys play a primary role in potassium homeostasis. The association between potassium (sK+) level and mortality or the need for kidney replacement therapy (KRT) during acute kidney injury (AKI) has not been adequately explored.Methods: In this prospective cohort study, AKI patients admitted to the Hospital Civil de Guadalajara were enrolled from August 2017 to June 2021 with AKI. We divided patients into 8 groups based on the serum potassium level trajectories up to ten days following hospitalization, (1) normokalemia (normoK), defined as sK+ values between 3.5 and 5.5 mEq/L; (2) corrected hyperkalemia (hyperK), sK+ > 5.5 mEq/L on hospital admission and decreased to normoK; (3) corrected hypokalemia (hypoK), sK+ < 3.5 mEq/L on hospital admission and increased to normoK; (4) fluctuating potassium, sK+ increased / decreased in and out of normoK parameters; (5) uncorrected hypoK, sK+ < 3.5 mEq/L; (6) normoK to hypoK, sK+ that were normal on hospital admission and decreased to hypoK and never went back to normal; (7) normoK to hyperK, sK+ that were normal on hospital admission and increased to hyperK and never went back to normal; (8) uncorrected hyperK, sK+ > 5.5 mEq/L. We assessed the association of serum potassium trajectories with mortality and the need for KRT (secondary objective). Results: A total of 311 AKI patients were included. The mean age was 52.6 years, and 182 (58.6%) were male. AKI stage 3 was present in 199 (63.9%). KRT started in 112 (36%) patients, and 66 (21.2%) died. After adjusting for confounders, 10-day hospital mortality was significantly higher in group 7 and 8 (OR, 1.37 and 1.63, p = <0.05, for both, respectevely), and KRT initiation was higher only in group 8 (OR 1.40, p = < 0.05) compared with group 1. Mortality in different subgroups of patients in group 8 did not change the primary results.Conclusion: In our prospective cohort, most patients with AKI had alterations in sK+. NormoK to hyperK and Uncorrected hyperK were associated with death, while only uncorrected hyperK was correlated with the need for KRT.