Urinary tract infection is associated with hypokalemia: a case control study

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Background

Hypokalemia is a common clinical problem. The association between urinary tract infection (UTI) and hypokalemia is not clear. Hypokalemia is common in patients with UTI in clinical observation. The aim of the study is to determine if UTI is associated with hypokalemia.

Methods

Patients hospitalized with UTI and the control group were retrieved from the Longitudinal Health Insurance Database 2005. The control group was patients hospitalized with other reasons and were matched for the confoundings of UTI and hypokalemia. We analyze the risk of hypokalemia using logistic regression and calculate the odds ratio (OR) and 95% confidence interval (CI) of OR.

Results

We analyzed 43,719 UTI patients and control patients. Hypokalemia was found in 4540 (10.4%) patients with UTI and 1842 (4.2%) control patients. The percentage of patients with hypokalemia was higher in UTI patients (chi-square, p < 0.001). UTI was associated with hypokalemia and the odds ratio (OR) was 2.27 [95% confidence interval (CI): 2.17–2.41]. Cerebrovascular accident, chronic obstructive pulmonary disease, hypertension, congestive heart failure, diarrhea, medications including thiazides, sulfonamides, xanthines, and laxatives were independently associated with hypokalemia. Recurrent UTI was associated with hypokalemia in UTI patients (OR: 1.13, 95% CI: 1.05–1.23, p < 0.001).

Conclusions

Urinary tract infection is associated with hypokalemia among inpatients. The association is independent of patients’ comorbidities and medications. Recurrent UTI is associated with increased hypokalemia in UTI patients.

Related collections

Most cited references 20

Record: found
Abstract: found
Article: found

Is Open Access

An introduction to the epidemiology and burden of urinary tract infections

Martha Medina, Edgardo Castillo-Pino (2019)

Urinary tract infections (UTIs) are the most common outpatient infections, with a lifetime incidence of 50−60% in adult women. This is a narrative review aimed at acting as an introduction to the epidemiology and burden of UTIs. This review is based on relevant literature according to the experience and expertise of the authors. The prevalence of UTI increases with age, and in women aged over 65 is approximately double the rate seen in the female population overall. Etiology in this age group varies by health status with factors such as catheterization affecting the likelihood of infection and the pathogens most likely to be responsible. In younger women, increased sexual activity is a major risk factor for UTIs and recurrence within 6 months is common. In the female population overall, more serious infections such as pyelonephritis are less frequent but are associated with a significant burden of care due to the risk of hospitalization. Healthcare-associated UTIs (HAUTIs) are the most common form of healthcare-acquired infection. Large global surveys indicate that the nature of pathogens varies between the community and hospital setting. In addition, the pathogens responsible for HAUTIs vary according to region making adequate local data key to infection control. UTIs create a significant societal and personal burden, with a substantial number of medical visits in the United States every year being related to UTIs. European data indicate that recurrent infections are related to increased absenteeism and physician visits. In addition, quality of life measures are significantly impacted in women suffering from recurrent UTIs. Data suggest that nonantimicrobial prophylactic strategies offer an opportunity to reduce both the rate of UTIs and the personal burden experience by patients.

0 comments Cited 165 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: found

Is Open Access

Association of Serum Potassium with All-Cause Mortality in Patients with and without Heart Failure, Chronic Kidney Disease, and/or Diabetes

Allan J Collins, Bertram Pitt, Nancy Reaven … (2017)

Background: The relationship between serum potassium, mortality, and conditions commonly associated with dyskalemias, such as heart failure (HF), chronic kidney disease (CKD), and/or diabetes mellitus (DM) is largely unknown. Methods: We reviewed electronic medical record data from a geographically diverse population ( n = 911,698) receiving medical care, determined the distribution of serum potassium, and the relationship between an index potassium value and mortality over an 18-month period in those with and without HF, CKD, and/or DM. We examined the association between all-cause mortality and potassium using a cubic spline regression analysis in the total population, a control group, and in HF, CKD, DM, and a combined cohort. Results: 27.6% had a potassium <4.0 mEq/L, and 5.7% had a value ≥5.0 mEq/L. A U-shaped association was noted between serum potassium and mortality in all groups, with lowest all-cause mortality in controls with potassium values between 4.0 and <5.0 mEq/L. All-cause mortality rates per index potassium between 2.5 and 8.0 mEq/L were consistently greater with HF 22%, CKD 16.6%, and DM 6.6% vs. controls 1.2%, and highest in the combined cohort 29.7%. Higher mortality rates were noted in those aged ≥65 vs. 50-64 years. In an adjusted model, all-cause mortality was significantly elevated for every 0.1 mEq/L change in potassium <4.0 mEq/L and ≥5.0 mEq/L. Diuretics and renin-angiotensin-aldosterone system inhibitors were related to hypokalemia and hyperkalemia respectively. Conclusion: Mortality risk progressively increased with dyskalemia and was differentially greater in those with HF, CKD, or DM.

0 comments Cited 133 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: found

Is Open Access

Hypokalemia-Induced Arrhythmias and Heart Failure: New Insights and Implications for Therapy

Jonas Skogestad, Jan Aronsen (2018)

Routine use of diuretics and neurohumoral activation make hypokalemia (serum K+ < 3. 5 mM) a prevalent electrolyte disorder among heart failure patients, contributing to the increased risk of ventricular arrhythmias and sudden cardiac death in heart failure. Recent experimental studies have suggested that hypokalemia-induced arrhythmias are initiated by the reduced activity of the Na+/K+-ATPase (NKA), subsequently leading to Ca2+ overload, Ca2+/Calmodulin-dependent kinase II (CaMKII) activation, and development of afterdepolarizations. In this article, we review the current mechanistic evidence of hypokalemia-induced triggered arrhythmias and discuss how molecular changes in heart failure might lower the threshold for these arrhythmias. Finally, we discuss how recent insights into hypokalemia-induced arrhythmias could have potential implications for future antiarrhythmic treatment strategies.

0 comments Cited 41 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Contributors

Che-Yi Chou:

ORCID: http://orcid.org/0000-0003-4029-9097

cychou.chou@gmail.com

Journal

Journal ID (nlm-ta): BMC Urol

Journal ID (iso-abbrev): BMC Urol

Title: BMC Urology

Publisher: BioMed Central (London )

ISSN (Electronic): 1471-2490

Publication date (Electronic): 20 July 2020

Publication date PMC-release: 20 July 2020

Publication date Collection: 2020

Volume: 20

Electronic Location Identifier: 108

Affiliations

[1 ]GRID grid.413535.5, ISNI 0000 0004 0627 9786, Department of Neurology, , Sijhih Cathay General Hospital, ; No.2, Ln. 59, Jiancheng Rd., Sijhih Dist, New Taipei City, 221 Taiwan

[2 ]GRID grid.412896.0, ISNI 0000 0000 9337 0481, Graduate Institute of Biomedical Informatics, , Taipei Medical University, ; No. 252, Wu-Xing Street, Taipei, 110 Taiwan

[3 ]GRID grid.412896.0, ISNI 0000 0000 9337 0481, Department of Pediatrics, School of Medicine, College of Medicine, , Taipei Medical University, ; No. 252, Wu-Xing Street, Taipei, 110 Taiwan

[4 ]GRID grid.412897.1, ISNI 0000 0004 0639 0994, Department of Laboratory Medicine, , Taipei Medical University Hospital, ; No. 252, Wu-Xing Street, Taipei, 110 Taiwan

[5 ]GRID grid.412146.4, ISNI 0000 0004 0573 0416, Department of Information Management, , National Taipei University of Nursing and Health Science, ; No. 365, Mingde Rd, Taipei, 112 Taiwan

[6 ]GRID grid.252470.6, ISNI 0000 0000 9263 9645, Division of Nephrology, , Asia University Hospital, ; NO 222, Fuxin Rd, Wufeng Dist, Taichung, 413 Taiwan

[7 ]GRID grid.252470.6, ISNI 0000 0000 9263 9645, Department of Post-baccalaureate Veterinary Medicine, , Asia University, ; NO 222, Fuxin Rd, Wufeng Dist, Taichung, 413 Taiwan

[8 ]GRID grid.411508.9, ISNI 0000 0004 0572 9415, Division of Nephrology, , China Medical University Hospital, ; Tacihung, Taiwan

Author information

Che-Yi Chou http://orcid.org/0000-0003-4029-9097

Article

Publisher ID: 678

DOI: 10.1186/s12894-020-00678-3

PMC ID: 7372809

PubMed ID: 32690002

SO-VID: 7e0b5d5b-cc1c-43fe-8c15-61f1e8fd21f9

License:

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

History

Date received : 15 February 2020

Date accepted : 14 July 2020

Custom metadata

ScienceOpen disciplines: Urology

Keywords: uti,hypokalemia,recurrent uti,comorbidities,diarrhea,thiazides,sulfonamides

Data availability:

ScienceOpen disciplines: Urology

Keywords: uti, hypokalemia, recurrent uti, comorbidities, diarrhea, thiazides, sulfonamides

Urinary tract infection is associated with hypokalemia: a case control study

Read this article at

Abstract

Background

Methods

Results

Conclusions

Related collections

Decoding Infection and Transmission

Most cited references 20

An introduction to the epidemiology and burden of urinary tract infections

Association of Serum Potassium with All-Cause Mortality in Patients with and without Heart Failure, Chronic Kidney Disease, and/or Diabetes

Hypokalemia-Induced Arrhythmias and Heart Failure: New Insights and Implications for Therapy

Author and article information

Contributors

Journal

Affiliations

Author information

Article

History

Categories

Custom metadata

Comments

Comment on this article

Similar content 565

Most referenced authors 149