Clinical significance and correlates of whole body potassium status in patients with liver cirrhosis

This study investigates whole body potassium status and its associations wi th disease stage, nutritional status, and prognosis in patients with liver cirrhosis, Two hundred and twenty-five patients were assessed for disease s tage total body potassium (TBP), anthropometric muscle mass, and energy exp enditure. Subsets of patients were investigated by quantitative liver funct ion tests or followed for survival. Patients with liver disease had lost 32 .6% of TBP as compared to controls or 22.0-32.9% as compared to predictive equations. Potassium loss was independent of Child-Pugh class (A, 32.1%; B, 32.3%; C, 35.2%) as was whole body muscle mass (A, 19.5 kg; B, 18.8 kg; C, 20.1 kg). Potassium loss was not associated with diuretic therapy and not enhanced in alcoholic cirrhosis, But muscle mass, resting energy expenditur e (REE) and ascites grade correlated with potassium loss (multiple r = 0.40 P < 0.01). Patients with potassium loss > 35% had reduced survival, but th is association was not independent of Child-Pugh class. Thus, TBP loss is n ot related to disease stage, liver function, diuretic treatment or origin o f liver disease, but related to muscle mass, energy expenditure, and ascite s, and therefore reflects modifications in body composition and metabolism. TBP status does, however, not add significantly to the prognostic power of the established Child-Pugh scoring system. (C) 1999 Elsevier Science Irela nd Ltd. All rights reserved.