Siddiqi Nauman, El Shahat Osama, Bokhari Ebtisam, Roujouleh Haytham, Hamid M Hisham, Sheikh Iftikhar, El-Sayed Hassan, Saleh Ayman, Seddik Ayman
Consultant Nephrology, Department of Medicine, King Fahd Armed Forces Hospital, Jeddah, Saudi Arabia.
Saudi J Kidney Dis Transpl. 2009 Nov;20(6):1018-22.
Hyperkalemia is common in patients with ESRD and may contribute to mortality. Dates have been reported to be high in potassium content. One of the concerns on hemodialysis (HD) is convincing patients to give up ingestion of dates as a part of their diet. To determine the effect of dates on serum potassium on patients, we studied 9 (M: F, 6:3, mean age 47.6) non diabetic patients on chronic hemodialysis, without evidence of hyperkalemia on monthly labs. Nearly all the patients had been on dialysis for an average of four years. The average monthly potassium was 4.6 mmol/L. The patients ingested 100 gm of dates (Rothana and Sukari) on two separate dialysis sessions. Serum potassium was measured at two and four hours post ingestion along with ECG monitoring. The patients underwent their regular dialysis as scheduled. The patients acted as their own controls and underwent the same protocol with 20meq of KCl on a separate session. The potassium levels did not change significantly over the four hours with either variety of dates or with potassium solution. Combining the two types of dates resulted in a trend towards higher potassium levels than with KCl, but it did not reach statistical significance. We conclude that in selected HD patients without hyperkalemia, ingestion of a few dates does not cause significant hyperkalemia and could be allowed on days of dialysis prior to their dialysis sessions.
高钾血症在终末期肾病患者中很常见,可能会导致死亡。据报道,海枣的钾含量很高。血液透析(HD)过程中的一个问题是说服患者放弃将海枣作为饮食的一部分。为了确定海枣对患者血清钾的影响,我们研究了9名(男:女,6:3,平均年龄47.6岁)接受慢性血液透析的非糖尿病患者,他们每月的实验室检查中没有高钾血症的证据。几乎所有患者平均已透析四年。平均每月血钾为4.6 mmol/L。患者在两次单独的透析过程中摄入100克海枣(Rothana和Sukari品种)。在摄入后两小时和四小时测量血清钾,并进行心电图监测。患者按计划进行常规透析。患者作为自身对照,在另一次透析过程中摄入20毫当量氯化钾,采用相同方案。无论是哪种海枣品种还是氯化钾溶液,血钾水平在四小时内均未显著变化。将两种海枣品种的结果合并后,血钾水平有高于氯化钾的趋势,但未达到统计学意义。我们得出结论,在没有高钾血症的特定血液透析患者中,摄入少量海枣不会导致显著的高钾血症,并且在透析日透析前可以食用。