Association between serum potassium and risk of all‐cause mortality among chronic kidney diseases patients: A systematic review and dose–response meta‐analysis of more than one million participants

We aimed to perform a meta‐analysis, using prospective cohort studies, to test the association between serum potassium and all‐cause mortality among chronic kidney diseases (CKD) patients. A systematic search was performed using PubMed‐MEDLINE and Scopus, up to July 2020. Prospective cohort studies which reported risk estimates of all‐cause mortality in CKD patients with different serum potassium levels were included in the present meta‐analysis. Thirteen studies were included in the analysis. A nonlinear dose–response meta‐analysis suggested that there is a J‐shaped association between serum potassium levels and the risk of all‐cause mortality, with a nadir at serum potassium of 4.5 mmol/L. Subgroup analyses indicated that the strength and shape of the association between serum potassium and all‐cause mortality may be influenced by age. Our meta‐analysis provides supportive evidence that there is a J‐shape association between serum potassium and all‐cause mortality among CKD patients.