Krämer B K, Ulshöfer T M, Müller G A, Ress K M, Risler T
Department of Internal Medicine, University of Tübingen, FRG.
Int J Artif Organs. 1990 Jan;13(1):32-8.
In order to clarify the influence of serum potassium, serum sodium and plasma angiotensin II concentrations on aldosterone release during hemodialysis (HD), six chronic hemodialysis patients were studied during HD with varying dialysate sodium concentrations and different buffers. Plasma aldosterone concentrations were higher during acetate than bicarbonate HD, during low sodium compared to high sodium HD, and were correlated inversely to serum sodium concentrations. The decline in plasma aldosterone concentrations during HD paralleled the decrease in serum potassium concentrations, and plasma aldosterone concentrations were correlated with serum potassium concentrations. In addition, plasma aldosterone and plasma angiotensin II concentrations were correlated significantly. It is proposed that serum potassium and the renin-angiotensin system are the main factors of aldosterone release during hemodialysis, while serum sodium per se seems to be of less importance. The dialysate buffer employed also plays a role in aldosterone regulation (via the renin-angiotensin system).
为阐明血液透析（HD）期间血清钾、血清钠和血浆血管紧张素II浓度对醛固酮释放的影响，对6例慢性血液透析患者在使用不同透析液钠浓度和不同缓冲液的血液透析过程中进行了研究。与碳酸氢盐HD相比，醋酸盐HD期间血浆醛固酮浓度更高；与高钠HD相比，低钠HD期间血浆醛固酮浓度更高，且血浆醛固酮浓度与血清钠浓度呈负相关。血液透析期间血浆醛固酮浓度的下降与血清钾浓度的降低平行，且血浆醛固酮浓度与血清钾浓度相关。此外，血浆醛固酮和血浆血管紧张素II浓度显著相关。研究表明，血清钾和肾素-血管紧张素系统是血液透析期间醛固酮释放的主要因素，而血清钠本身似乎不太重要。所使用的透析液缓冲液在醛固酮调节中也起作用（通过肾素-血管紧张素系统）。
