Kovesdy Csaba P
University of Tennessee Health Science Center, Memphis, Tennessee, USA.
Memphis Veterans Affairs Medical Center, Memphis, Tennessee, USA.
Kidney Int Suppl (2011). 2016 Apr;6(1):3-6. doi: 10.1016/j.kisu.2016.01.002. Epub 2016 Mar 14.
Hyperkalemia represents one of the most important acute electrolyte abnormalities, due to its potential for causing life-threatening arrhythmias. In individuals with normal kidney function hyperkalemia occurs relatively infrequently, but it can be much more common in patients who have certain predisposing conditions. Patients with chronic kidney disease are the most severely affected group, by virtue of their decreased ability to excrete potassium and because they commonly have additional predisposing conditions that often cluster within patients with chronic kidney disease. These conditions include comorbidities (e.g., diabetes mellitus) and the use of various medications, of which the most important are renin-angiotensin-aldosterone system inhibitors (RAASis). Hyperkalemia is associated with increased risk for all-cause mortality and for malignant arrhythmias such as ventricular fibrillation. The increased risk for adverse outcomes is observed even in serum potassium ranges that are often not considered targets for therapeutic interventions. The heightened risk of mortality associated with hyperkalemia is present in all patient populations, even those in whom hyperkalemia occurs otherwise rarely, such as individuals with normal kidney function.
高钾血症是最重要的急性电解质异常之一，因为它有可能导致危及生命的心律失常。在肾功能正常的个体中，高钾血症相对较少发生，但在有某些易感因素的患者中可能更为常见。慢性肾脏病患者是受影响最严重的群体，这是由于他们排泄钾的能力下降，并且他们通常还有其他常在慢性肾脏病患者中聚集的易感因素。这些因素包括合并症（如糖尿病）和使用各种药物，其中最重要的是肾素-血管紧张素-醛固酮系统抑制剂（RAASi）。高钾血症与全因死亡率增加以及恶性心律失常（如室颤）风险增加相关。即使在通常不被视为治疗干预目标的血清钾范围内，也观察到不良结局风险增加。高钾血症相关的死亡风险增加存在于所有患者群体中，即使是那些高钾血症原本很少发生的人群，如肾功能正常的个体。
