{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T10:20:53Z","timestamp":1781259653349,"version":"3.54.1"},"reference-count":23,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2021,7,7]],"date-time":"2021-07-07T00:00:00Z","timestamp":1625616000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,7,26]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Few studies have examined that the role of serum potassium concentration [K+] variability on clinical outcomes is still poorly investigated. The aim of our study was to analyse the association between serum ([K+]) disorders, with focus on [K+] variability and mortality in a large, unselected cohort of hospitalized patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We performed a retrospective observational cohort study on the inpatient population admitted to Fondazione Policlinico Universitario A. Gemelli IRCCS between 1 January 2010 and 31 December 2014 with inclusion of adult patients with \u22652 [K+] measurements. The outcome of interest was in-hospital mortality. The exposures of interest were [K+] fluctuations, hypohyperkalaemia and mixed dyskalaemia during hospital stay. [K+] variability was evaluated using the coefficient of variation (CV). Logistic regression models were fitted to obtain odds ratios (ORs) and 95% confidence intervals (CIs) for the association between the exposures of interest and in-hospital death.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Overall, 64\u2009507 patients met our inclusion criteria. During a median follow-up of 8\u2009days, 965 patients (1.5%) died. Multivariable adjusted logistic models suggested a higher risk for death in patients in the third (OR = 1.45, 95% CI 1.13\u20131.88; P\u2009=\u20090.003) and fourth (OR = 3.30, 95% CI 2.64\u20134.16; P\u2009&amp;lt;\u20090.001) highest quartiles of [K+] CV compared with those in the lowest quartile with a significant linear trend across quartiles (P-trend\u2009&amp;lt;0.001). Results did not change after restricting the analyses to patients with normokalaemia (NK). All [K+] disorders were independently associated with an increased risk of in-hospital death compared with NK.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>High [K+] variability is an independent risk factor of in-hospital mortality, even within the normal [K+] range.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ndt\/gfab211","type":"journal-article","created":{"date-parts":[[2021,7,3]],"date-time":"2021-07-03T19:09:32Z","timestamp":1625339372000},"page":"1482-1487","source":"Crossref","is-referenced-by-count":14,"title":["Serum potassium variability is associated with increased mortality in a large cohort of hospitalized patients"],"prefix":"10.1093","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2298-1420","authenticated-orcid":false,"given":"Gianmarco","family":"Lombardi","sequence":"first","affiliation":[{"name":"U.O.C. Nefrologia, Azienda Ospedaliera Universitaria Integrata di Verona , Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5733-2370","authenticated-orcid":false,"given":"Giovanni","family":"Gambaro","sequence":"additional","affiliation":[{"name":"U.O.C. Nefrologia, Azienda Ospedaliera Universitaria Integrata di Verona , Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1379-022X","authenticated-orcid":false,"given":"Pietro Manuel","family":"Ferraro","sequence":"additional","affiliation":[{"name":"U.O.S. Terapia Conservativa della Malattia Renale Cronica, U.O.C. Nefrologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS , Rome, Italy"},{"name":"Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Universit\u00e0 Cattolica del Sacro Cuore , Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,7,7]]},"reference":[{"key":"2022072612293673600_gfab211-B1","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1016\/S0140-6736(98)85044-7","article-title":"Potassium","volume":"352","author":"Halperin","year":"1998","journal-title":"Lancet"},{"key":"2022072612293673600_gfab211-B2","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1056\/NEJMra1313341","article-title":"An integrated view of potassium homeostasis","volume":"373","author":"Gumz","year":"2015","journal-title":"N Engl J Med"},{"key":"2022072612293673600_gfab211-B3","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1016\/j.jacc.2003.06.021","article-title":"What is the optimal serum potassium level in cardiovascular patients?","volume":"43","author":"Macdonald","year":"2004","journal-title":"J Am Coll Cardiol"},{"key":"2022072612293673600_gfab211-B4","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1016\/S0749-0704(01)00009-4","article-title":"Disorders of potassium homeostasis","volume":"18","author":"Gennari","year":"2002","journal-title":"Crit Care Clin"},{"key":"2022072612293673600_gfab211-B5","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1056\/NEJM199808133390707","article-title":"Hypokalemia","volume":"339","author":"Gennari","year":"1998","journal-title":"N Engl J Med"},{"key":"2022072612293673600_gfab211-B6","doi-asserted-by":"crossref","first-page":"1663","DOI":"10.2146\/ajhp040300","article-title":"Treatment of electrolyte disorders in adult patients in the intensive care unit","volume":"62","author":"Kraft","year":"2005","journal-title":"Am J Health Syst Pharm"},{"key":"2022072612293673600_gfab211-B7","doi-asserted-by":"crossref","first-page":"1272","DOI":"10.2215\/CJN.00960112","article-title":"Serum potassium and cause-specific mortality in a large peritoneal dialysis cohort","volume":"7","author":"Torl\u00e9n","year":"2012","journal-title":"Clin J Am Soc Nephrol"},{"key":"2022072612293673600_gfab211-B8","doi-asserted-by":"crossref","first-page":"1834","DOI":"10.1007\/s00134-012-2636-7","article-title":"Association between hyperkalemia at critical care initiation and mortality","volume":"38","author":"McMahon","year":"2012","journal-title":"Intensive Care Med"},{"key":"2022072612293673600_gfab211-B9","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1186\/s13613-019-0573-0","article-title":"Association between potassium concentrations, variability and supplementation, and in-hospital mortality in ICU patients: a retrospective analysis","volume":"9","author":"Engelhardt","year":"2019","journal-title":"Ann Intensive Care"},{"key":"2022072612293673600_gfab211-B10","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1186\/s13054-014-0720-9","article-title":"The relationship between serum potassium, potassium variability and in-hospital mortality in critically ill patients and a before-after analysis on the impact of computer-assisted potassium control","volume":"19","author":"Hessels","year":"2015","journal-title":"Crit Care"},{"key":"2022072612293673600_gfab211-B11","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1177\/0003319717740004","article-title":"Potassium fluctuations are associated with inhospital mortality from acute myocardial infarction. 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