上海交通大学学报(医学版) ›› 2023, Vol. 43 ›› Issue (4): 507-513.doi: 10.3969/j.issn.1674-8115.2023.04.015
• 综述 • 上一篇
收稿日期:
2022-09-08
接受日期:
2023-02-14
出版日期:
2023-04-28
发布日期:
2023-04-28
通讯作者:
张伟明
E-mail:13326393425@163.com;weimingzh1965@163.com
作者简介:
门 如(1999—),女,住院医师,硕士生;电子信箱:13326393425@163.com。
MEN Ru(), ZHU Minxia, ZHANG Weiming(
)
Received:
2022-09-08
Accepted:
2023-02-14
Online:
2023-04-28
Published:
2023-04-28
Contact:
ZHANG Weiming
E-mail:13326393425@163.com;weimingzh1965@163.com
摘要:
维持性血液透析是终末期肾病患者肾脏替代治疗的方式之一,血钾异常是维持性血液透析患者常见的代谢并发症,透析前高钾血症、透析期间和透析后低钾血症均可能与维持性血透患者全因死亡、心血管事件死亡有关。目前,血钾波动对患者预后的影响受到广泛关注,因维持性血液透析的间歇性治疗特点,患者经历更频繁的血钾波动,血钾变异性能较好地反映患者血钾稳态情况,血钾变异性大是维持性血液透析患者不良预后的潜在危险因素。此外,透析过程中患者血钾水平的急性变化易增加患者恶性心律失常、心源性猝死和其他不良预后的发生风险。血清-透析液钾浓度梯度是影响钾清除的重要因素,其他透析液成分同样影响血钾清除。因此,加强患者血钾水平的监测和管理,选择适宜的透析液钾浓度,个体化制定透析处方有利于维持性血液透析患者维持钾稳态,减少血钾异常发生,改善预后。该文简要阐述维持性血液透析患者血钾水平的变化特点,讨论维持性血液透析患者血钾水平对预后的影响,强调血钾变异与患者预后的关系以及透析液成分对血钾水平稳定的影响。
中图分类号:
门如, 朱旻霞, 张伟明. 维持性血液透析患者血钾水平及其对预后影响[J]. 上海交通大学学报(医学版), 2023, 43(4): 507-513.
MEN Ru, ZHU Minxia, ZHANG Weiming. Serum potassium level in maintenance hemodialysis patients and its effect on outcome[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2023, 43(4): 507-513.
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