Schück O, Teplan V, Nádvorníková H
Institut klinické a experimentální medicíny, Praha.
Vnitr Lek. 1991 Jun;37(6):531-4.
In 19 patients with chronic renal failure and still preserved residual diuresis the inulin clearance (Cin) and renal potassium excretion were assessed before and 12 hours after haemodialysis (HD), combined with conventional ultrafiltration. The mean value of Cin after HD declined significantly (p less than 0.001). As a result of HD a significant decline of the plasma potassium concentration occurred (p less than 0.005) and of the urinary excretion (p less than 0.01). The mean value of the fractional potassium excretion (FEK) did not change significantly as a result of HD. The reduced urinary K excretion after HD correlated significantly (p less than 0.05) with the decline of Cin. The findings suggest that the decline of the urinary potassium excretion after HD is above all due to a decline of the glomerular filtration rate. The tubular potassium secretion does not change significantly under these conditions. These findings support indirectly the idea that the increased tubular potassium secretion in residual nephrons in patients with chronic renal failure is not conditioned by retention of low-molecular dialysable substances.
对19例仍保留残余尿量的慢性肾衰竭患者,在血液透析(HD)联合常规超滤治疗前及治疗后12小时,评估菊粉清除率(Cin)和肾脏钾排泄情况。HD后Cin的平均值显著下降(p<0.001)。HD导致血浆钾浓度显著下降(p<0.005)以及尿钾排泄显著下降(p<0.01)。HD后钾排泄分数(FEK)的平均值无显著变化。HD后尿钾排泄减少与Cin下降显著相关(p<0.05)。研究结果表明,HD后尿钾排泄减少主要是由于肾小球滤过率下降。在这些情况下,肾小管钾分泌无显著变化。这些发现间接支持了这样一种观点,即慢性肾衰竭患者残余肾单位中肾小管钾分泌增加并非由低分子可透析物质潴留所导致。