Stevens M S, Dunlay R W
Department of Medicine and Pharmacology, Creighton University, Omaha, Nebraska, USA.
Int Urol Nephrol. 2000;32(2):177-80. doi: 10.1023/a:1007135517950.
Evaluate the prevalence of hyperkalemia (potassium > 5.5 mmol/l) in hospitalized patients not on dialysis, as well as the association of medications, impaired renal function and comorbid conditions with hyperkalemia.
A retrospective case-control method.
A tertiary care teaching hospital.
Hyperkalemic adults not on dialysis with age and sex matched controls.
None.
The use of medications associated with hyperkalemia and renal function using a calculated creatinine clearance were compared in the hyperkalemic and control groups.
35 adult patients with hyperkalemia who were not receiving dialysis were identified, with a prevalence in the hospitalized population of 3.3%. The hyperkalemic patients were older than the general hospital population (p < 0.05). Compared with controls, hyperkalemic patients: had a lower creatinine clearance (p < 0.05), were more likely to be taking angiotensin-converting enzyme inhibitors (p < 0.05), and had an increased frequency of diabetes mellitus (p < 0.001). All of the control patients survived their hospitalization, but the mortality rate in the hyperkalemic group was 17% (p < 0.0001). None of the deaths were directly attributable to hyperkalemia.
Hyperkalemia is more frequent in older patients and is usually mild. Hyperkalemia is associated with diabetes mellitus, diminished renal function and the use of angiotensin-converting enzyme inhibitors. An elevated serum potassium level in a hospitalized patient may be a marker for a significantly increased risk of death, which is due to underlying medical problems and is not a consequence of the hyperkalemia.
评估未接受透析治疗的住院患者高钾血症（血钾>5.5 mmol/L）的患病率，以及药物、肾功能损害和合并症与高钾血症的关联。
回顾性病例对照研究方法。
一家三级护理教学医院。
年龄和性别匹配的未接受透析治疗的高钾血症成年患者及对照。
无。
比较高钾血症组和对照组中与高钾血症相关药物的使用情况以及根据计算的肌酐清除率得出的肾功能。
确定了35例未接受透析治疗的高钾血症成年患者，在住院人群中的患病率为3.3%。高钾血症患者比普通住院人群年龄更大（p<0.05）。与对照组相比，高钾血症患者：肌酐清除率较低（p<0.05），更有可能正在服用血管紧张素转换酶抑制剂（p<0.05），糖尿病发病率更高（p<0.001）。所有对照患者住院期间均存活，但高钾血症组的死亡率为17%（p<0.0001）。所有死亡均非直接由高钾血症所致。
高钾血症在老年患者中更常见，且通常为轻度。高钾血症与糖尿病、肾功能减退及使用血管紧张素转换酶抑制剂有关。住院患者血清钾水平升高可能是死亡风险显著增加的一个标志，这是由于潜在的医疗问题所致，而非高钾血症的后果。
