Potassium Serum Levels in Peritoneal Dialysis:Harmful in Excess, Worse in Deficiency

The introduction of dialysis for the treatment of end-stage renal disease (ESRD) during the middle of the last century has completely changed the prognosis of ESRD patients helping to prevent several deaths from uremia, pulmonary edema and electrolyte disturbances. Nevertheless mortality rates remains extremely high and several risk factors contribute to such scenario, including the high prevalence of traditional risk factors as diabetes and hypertension, but also due risk factors related do chronic kidney disease and eventually to new risk factors introduced when a dialysis modality is initiated. Potassium disturbances are common and frequently associated with negative outcomes. In this paper we will focus on potassium disturbances in peritoneal dialysis patients. Particularly, we will discuss the role of hypokalemia in this population, comparing its prevalence in both dialysis modality and exploring the results of some important observational studies that investigated the negative association of low serum potassium levels with clinical outcomes including overall, cardiovascular and infectious mortality.