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Purpose: To determine seasonal variations in serum potassium levels among hemodialysis patients. Materials and Methods: This was a multicenter cohort study of patients whounderwent hemodialysis and were registered in DialysisNetat our four associated general hospitals between January and December 2016. Month-to-month potassium variabilitywas quantified as SD/√{n/(n-1)}, and a non-hierarchical method was used to cluster groups according to potassium trajectories. Seasonal variations in potassium levels were analyzed using a cosinor analysis. Results: The analysis was performed on 279 patients with a mean potassium level of 5.08±0.58 mmol/L. After clustering, 52.3%(n=146) of patients were included in the moderate group (K+, 4.6±0.4 mmol/L) and 47.7% (n=133) in the high group (K+, 5.6±0.4mmol/L). The mean potassium level peaked in January in the moderate group (4.83±0.74 mmol/L) and in August in the highgroup (5.51±0.70 mmol/L). In the high potassium group, potassium levels were significantly higher in summer than in autumn(p<0.001) and spring (p=0.007). Month-to-month potassium variability was greater in the high group than in the moderategroup (0.59±0.19 mmol/L vs. 0.52±0.21 mmol/L, respectively, p=0.012). Compared to patients in the first quartile of potassiumvariability (≤0.395 mmol/L), those with higher variability (2nd–4th quartiles) were 2.8–4.2 fold more likely to be in the high potassiumgroup. Conclusion: Different seasonal patterns of serum potassium were identified in the moderate and high potassium groups, withpotassium levels being significantly higher in the summer season in the high potassium group and in winter for the moderate potassiumgroup.
