Michelis M F
Nephrology Section, Lenox Hill Hospital, New York, NY 10021.
Am J Kidney Dis. 1990 Oct;16(4):296-9. doi: 10.1016/s0272-6386(12)80005-9.
Physiologic and pathologic events that occur in patients as they grow older may result in distal renal tubular dysfunction, as well as decreased levels of plasma renin activity and plasma aldosterone. Such alterations result in a tendency toward hyperkalemia. A syndrome termed hyporeninemic hypoaldosteronism, associated with hyperkalemia, has been frequently described in elderly patients. The common occurrence of hyperkalemia in the elderly may be aggravated by the use of drugs that either further suppress renin and/or aldosterone or interfere with distal tubular potassium excretion. Some patients with hyporeninemic hypoaldosteronism respond to diuretic therapy. The recognition of the possible development of severe hyperkalemia in the elderly patient may avoid serious and even fatal complications of this electrolyte disorder.
随着年龄增长，患者体内发生的生理和病理事件可能导致远端肾小管功能障碍，以及血浆肾素活性和血浆醛固酮水平降低。这些改变导致了高钾血症的倾向。一种与高钾血症相关的综合征，称为低肾素性低醛固酮血症，在老年患者中经常被描述。老年人中高钾血症的常见情况可能会因使用进一步抑制肾素和/或醛固酮或干扰远端肾小管钾排泄的药物而加重。一些低肾素性低醛固酮血症患者对利尿剂治疗有反应。认识到老年患者可能发生严重高钾血症，可避免这种电解质紊乱的严重甚至致命并发症。
