INTRODUCTION Although hyperkalemia and metabolic acidosis often co-occur in patients with chronic kidney disease (CKD), the prevalence of metabolic acidosis among patients with CKD and hyperkalemia is understudied. Therefore, we used medical record data from the Research Action for Health Network to estimate this prevalence. METHODS Adult patients with CKD stage 3-5, ≥ 1 outpatient potassium value > 5.0 mEq/l, and ≥ 1 outpatient bicarbonate value available were identified. Patients with end stage kidney disease (ESKD) in the prior year were excluded. The prevalence of metabolic acidosis in each calendar year from 2014 to 2017 among patients with CKD and hyperkalemia was estimated using two definitions of hyperkalemia (potassium > 5.0 mEq/l and > 5.5 mEq/l) and metabolic acidosis (bicarbonate < 18 mEq/l and < 22 mEq/l). RESULTS In the 2017 patient cohort and among patients with CKD and hyperkalemia, patients with metabolic acidosis were younger (69 versus 74 years), more likely to have advanced CKD (35% versus 13%), and use oral sodium bicarbonate (21% versus 4%) than patients without metabolic acidosis. The prevalence of metabolic acidosis (< 22 mEq/l) ranged from 25 to 29% when hyperkalemia was defined by potassium > 5.0 mEq/l and ranged from 33 to 39% when hyperkalemia was defined by potassium > 5.5 mEq/l. CONCLUSION Results demonstrated that prevalence estimates of metabolic acidosis varied based on the definition of hyperkalemia and metabolic acidosis utilized.

中文翻译：

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慢性肾病和高钾血症患者代谢性酸中毒的患病率。


简介 虽然高钾血症和代谢性酸中毒经常在慢性肾脏病 (CKD) 患者中同时发生，但 CKD 和高钾血症患者中代谢性酸中毒的患病率尚未得到充分研究。因此，我们使用健康研究行动网络的医疗记录数据来估计这种患病率。方法 确定 CKD 3-5 期、≥ 1 门诊钾值 > 5.0 mEq/l 和 ≥ 1 门诊可用碳酸氢盐值的成年患者。排除前一年患有终末期肾病（ESKD）的患者。使用高钾血症（钾 > 5.0 mEq/l 和 > 5.5 mEq/l）和代谢性酸中毒（碳酸氢盐 < 18 mEq/l 和 < 22 mEq/l)。结果 在 2017 年患者队列中，在 CKD 合并高钾血症患者中，代谢性酸中毒患者更年轻（69 岁对 74 岁），更有可能患有晚期 CKD（35% 对 13%），并使用口服碳酸氢钠（21% 对4%）比没有代谢性酸中毒的患者高。当高钾血症由钾 > 5.0 mEq/l 定义时，代谢性酸中毒 (< 22 mEq/l) 的患病率范围为 25% 至 29%；当高钾血症由钾 > 5.5 mEq/l 定义时，代谢性酸中毒的患病率范围为 33% 至 39% 。结论 结果表明，代谢性酸中毒的患病率估计因高钾血症和代谢性酸中毒的定义而异。