慢性肾脏病患者与非慢性肾脏病患者的酸碱及电解质紊乱：最新进展
Acid-Base and Electrolyte Disorders in Patients with and without Chronic Kidney Disease: An Update.
作者信息
Dhondup Tsering, Qian Qi
机构信息
Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA.
出版信息
Kidney Dis (Basel). 2017 Dec;3(4):136-148. doi: 10.1159/000479968. Epub 2017 Oct 5.
Abstract
Kidneys play a pivotal role in the maintenance and regulation of acid-base and electrolyte homeostasis, which is the prerequisite for numerous metabolic processes and organ functions in the human body. Chronic kidney diseases compromise the regulatory functions, resulting in alterations in electrolyte and acid-base balance that can be life-threatening. In this review, we discuss the renal regulations of electrolyte and acid-base balance and several common disorders including metabolic acidosis, alkalosis, dysnatremia, dyskalemia, and dysmagnesemia. Common disorders in chronic kidney disease are also discussed. The most recent and relevant advances on pathophysiology, clinical characteristics, diagnosis, and management of these conditions have been incorporated.
摘要
肾脏在维持和调节酸碱及电解质平衡中起着关键作用，而酸碱及电解质平衡是人体众多代谢过程和器官功能的先决条件。慢性肾脏病会损害调节功能，导致电解质和酸碱平衡改变，这可能危及生命。在本综述中，我们讨论了肾脏对电解质和酸碱平衡的调节以及几种常见病症，包括代谢性酸中毒、碱中毒、钠代谢紊乱、钾代谢紊乱和镁代谢紊乱。还讨论了慢性肾脏病中的常见病症。纳入了这些病症在病理生理学、临床特征、诊断和管理方面的最新相关进展。
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本文引用的文献
1
Genetics of Magnesium Disorders.镁紊乱的遗传学
Kidney Dis (Basel). 2017 Dec;3(3):85-97. doi: 10.1159/000477730. Epub 2017 Jul 5.
2
Short-Term Effects of Tolvaptan in Patients With Acute Heart Failure and Volume Overload.托伐普坦治疗急性心力衰竭伴容量超负荷患者的短期疗效。
J Am Coll Cardiol. 2017 Mar 21;69(11):1409-1419. doi: 10.1016/j.jacc.2016.12.035.
3
Ammonia Transporters and Their Role in Acid-Base Balance.氨转运体及其在酸碱平衡中的作用。
Physiol Rev. 2017 Apr;97(2):465-494. doi: 10.1152/physrev.00011.2016.
4
Efficacy and Safety of Tolvaptan in Patients Hospitalized With Acute Heart Failure.托伐普坦治疗急性心力衰竭住院患者的疗效和安全性。
J Am Coll Cardiol. 2017 Mar 21;69(11):1399-1406. doi: 10.1016/j.jacc.2016.09.004. Epub 2016 Sep 18.
5
Dysmagnesemia in Hospitalized Patients: Prevalence and Prognostic Importance.住院患者的低镁血症：患病率和预后意义。
Mayo Clin Proc. 2015 Aug;90(8):1001-10. doi: 10.1016/j.mayocp.2015.04.023.
6
Effect of Patiromer on Serum Potassium Level in Patients With Hyperkalemia and Diabetic Kidney Disease: The AMETHYST-DN Randomized Clinical Trial.聚磺苯乙烯钠散对高钾血症合并糖尿病肾病患者血钾水平的影响：AMEHTYST-DN 随机临床试验。
JAMA. 2015 Jul 14;314(2):151-61. doi: 10.1001/jama.2015.7446.
7
Hyponatremia and mortality risk: a Danish cohort study of 279 508 acutely hospitalized patients.低钠血症与死亡风险：一项对279508例急性住院患者的丹麦队列研究
Eur J Endocrinol. 2015 Jul;173(1):71-81. doi: 10.1530/EJE-15-0111.
8
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9
The role of pendrin in renal physiology.钠-碘协同转运体在甲状腺中的作用。
Annu Rev Physiol. 2015;77:363-78. doi: 10.1146/annurev-physiol-021014-071854.
10
A new era for the treatment of hyperkalemia?高钾血症治疗的新时代？
N Engl J Med. 2015 Jan 15;372(3):275-7. doi: 10.1056/NEJMe1414112. Epub 2014 Nov 21.
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