title: Race, Serum Potassium, and Associations With ESRD and Mortality.
abstract: BACKGROUND
  Recent studies suggest that potassium levels may differ by race. The basis for these differences and whether associations between potassium levels and adverse outcomes differ by race are unknown.
  
  
  METHODS
  Observational study.
  
  
  METHODS
  Associations between race and potassium level and the interaction of race and potassium level with outcomes were investigated in the Racial and Cardiovascular Risk Anomalies in Chronic Kidney Disease (RCAV) Study, a cohort of US veterans (N=2,662,462). Associations between African ancestry and potassium level were investigated in African Americans in the Atherosclerosis Risk in Communities (ARIC) Study (N=3,450).
  
  
  METHODS
  Race (African American vs non-African American and percent African ancestry) for cross-sectional analysis; serum potassium level for longitudinal analysis.
  
  
  RESULTS
  Potassium level for cross-sectional analysis; mortality and end-stage renal disease for longitudinal analysis.
  
  
  RESULTS
  The RCAV cohort was 18% African American (N=470,985). Potassium levels on average were 0.162mmol/L lower in African Americans compared with non-African Americans, with differences persisting after adjustment for demographics, comorbid conditions, and potassium-altering medication use. In the ARIC Study, higher African ancestry was related to lower potassium levels (-0.027mmol/L per each 10% African ancestry). In both race groups, higher and lower potassium levels were associated with mortality. Compared to potassium level of 4.2mmol/L, mortality risk associated with lower potassium levels was lower in African Americans versus non-African Americans, whereas mortality risk associated with higher levels was slightly greater. Risk relationships between potassium and end-stage renal disease were weaker, with no difference by race.
  
  
  CONCLUSIONS
  No data for potassium intake.
  
  
  CONCLUSIONS
  African Americans had slightly lower serum potassium levels than non-African Americans. Consistent associations between potassium levels and percent African ancestry may suggest a genetic component to these differences. Higher and lower serum potassium levels were associated with mortality in both racial groups.
authors.affiliation: Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD.
authors.forename: Yan
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD.
authors.forename: Yingying
authors.initials: Y
authors.lastname: Sang
authors.affiliation: Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD.
authors.forename: Shoshana H
authors.initials: SH
authors.lastname: Ballew
authors.affiliation: Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD.
authors.forename: Adrienne
authors.initials: A
authors.lastname: Tin
authors.affiliation: Division of Nephrology, Geisinger Health System, Danville, PA.
authors.forename: Alex R
authors.initials: AR
authors.lastname: Chang
authors.affiliation: Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD.
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Matsushita
authors.affiliation: Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD.
authors.forename: Josef
authors.initials: J
authors.lastname: Coresh
authors.affiliation: Harold Simmons Center for Chronic Disease Research & Epidemiology, University of California Irvine Medical Center, Irvine, CA; Division of Nephrology & Hypertension, University of California Irvine Medical Center, Orange, CA.
authors.forename: Kamyar
authors.initials: K
authors.lastname: Kalantar-Zadeh
authors.affiliation: Division of Nephrology, Department of Medicine, University of Tennessee Health Science Center, Memphis, TN; Department of Transplantation and Surgery, Semmelweis University, Budapest, Hungary.
authors.forename: Miklos Z
authors.initials: MZ
authors.lastname: Molnar
authors.affiliation: Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD; Division of Nephrology, Department of Medicine, Johns Hopkins University, Baltimore, MD. Electronic address: mgrams2@jhmi.edu.
authors.forename: Morgan E
authors.initials: ME
authors.lastname: Grams
mesh_terms: D001741:Black or African American; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D011188:Potassium / Q000097:blood*; D011446:Prospective Studies; D044469:Racial Groups
chemical_list: D011188:Potassium
keywords: African American; African ancestry; Race; end-stage renal disease (ESRD); genetic risk factor; hyperkalemia; hypokalemia; kidney disease; mortality; racial differences; serum potassium