{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T22:27:33Z","timestamp":1792794453783,"version":"4.5.0"},"reference-count":36,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2018,8,6]],"date-time":"2018-08-06T00:00:00Z","timestamp":1533513600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004325","name":"AstraZeneca","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004325","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Swedish Heart and Lung Foundation"},{"DOI":"10.13039\/501100004348","name":"Stockholm County Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004348","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Vifor Fresenius Medical Care Renal Pharma","id":[{"id":"https:\/\/ror.org\/05rs7tq63","id-type":"ROR","asserted-by":"crossref"}]},{"name":"Martin Rind\u2019s and Westman\u2019s Swedish Foundations"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Small-scale studies suggest that hyperkalaemia is a less threatening condition in chronic kidney disease (CKD), arguing adaptation\/tolerance to potassium (K+) retention. This study formally evaluates this hypothesis by estimating the distribution of plasma K+ and its association with mortality across CKD stages.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This observational study included all patients undergoing plasma K+ testing in Stockholm during 2006\u201311. We randomly selected one K+ measurement per patient and constructed a cross-sectional cohort with mortality follow-up. Covariates included demographics, comorbidities, medications and estimated glomerular filtration rate (eGFR). We estimated K+ distribution and defined K+ ranges associated with 90-, 180- and 365-day mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Included were 831\u2009760 participants, of which 70\u00a0403 (8.5%) had CKD G3 (eGFR\u2009&amp;lt;60\u201330\u2009mL\/min) and 8594 (1.1%) had CKD G4\u2013G5 (eGFR\u2009&amp;lt;30\u2009mL\/min). About 66\u00a0317 deaths occurred within a year. Adjusted plasma K+ increased across worse CKD stages: from median 3.98 (95% confidence interval 3.49\u20134.59) for eGFR\u2009&amp;gt;90 to 4.43 (3.22\u20135.65) mmol\/L for eGFR\u2009\u226415\u2009mL\/min\/1.73 m2. The association between K+ and mortality was U-shaped, but it flattened at lower eGFR strata and shifted upwards. For instance, the range where the 90-day mortality risk increased by no more than 100% was 3.45\u20134.94\u2009mmol\/L in eGFR\u2009&amp;gt;60\u2009mL\/min, but was 3.36\u20135.18\u2009 in G3 and 3.26\u20135.53 mmol\/L in G4\u2013G5. In conclusion, CKD stage modifies K+ distribution and the ranges that predict mortality in the community.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Although this study supports the view that hyperkalaemia is better tolerated with worse CKD, it challenges the current use of a single optimal K+ range for all patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ndt\/gfy249","type":"journal-article","created":{"date-parts":[[2018,7,19]],"date-time":"2018-07-19T18:50:37Z","timestamp":1532026237000},"page":"1534-1541","source":"Crossref","is-referenced-by-count":57,"title":["Plasma potassium ranges associated with mortality across stages of chronic kidney disease: the Stockholm CREAtinine Measurements (SCREAM) project"],"prefix":"10.1093","volume":"34","author":[{"given":"Alessandro","family":"Gasparini","sequence":"first","affiliation":[{"name":"Department of Health Sciences, University of Leicester, Leicester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie","family":"Evans","sequence":"first","affiliation":[{"name":"Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Barany","sequence":"first","affiliation":[{"name":"Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hairong","family":"Xu","sequence":"first","affiliation":[{"name":"AstraZeneca, Gaithersburg, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomas","family":"Jernberg","sequence":"first","affiliation":[{"name":"Department of Clinical Sciences, Danderyd University Hospital, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johan","family":"\u00c4rnl\u00f6v","sequence":"first","affiliation":[{"name":"Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars H","family":"Lund","sequence":"first","affiliation":[{"name":"Department of Medicine, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan-Jes\u00fas","family":"Carrero","sequence":"first","affiliation":[{"name":"Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2018,8,6]]},"reference":[{"key":"2020070205435818300_gfy249-B1","doi-asserted-by":"crossref","first-page":"3155","DOI":"10.1681\/ASN.2016121344","article-title":"How 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