Bai C, Shang J, Kang D, Yu W, Zhang F L, Zhang W F, Wu F, Guo R X, Zhang Y D, Zhao Z Z
Department of Nephrology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China.
Zhonghua Yi Xue Za Zhi. 2020 Oct 20;100(38):2997-3000. doi: 10.3760/cma.j.cn112137-20200629-01990.
To investigate the efficacy of sodium zirconium cyclosilicate on emergency correction of hyperkalemia in chronic kidney disease patients. Patients with chronic kidney disease who were admitted to the Department of Nephrology of the First Affiliated Hospital of Zhengzhou University from May to June 2020 were selected. Those who had hyperkalemia and took sodium zirconium cyclosilicate powder were finally included. The patient's clinical data and laboratory results were collected. A total of 24 results were included from 21 patients. The age of patients was (48.9±13.5) years old. Fourteen patients were male, and 7 patients were female. After 2 hours of administration, the venous potassium level decreased from (5.85±0.52) mmol/L to (5.15±0.43) mmol/L (0.001, 21), with an average decline of (0.71±0.43) mmol/L. Meanwhile, the arterial potassium level decreased from (5.50±0.40) mmol/L to (4.88±0.33) mmol/L (0.001, 10), with an average decline of (0.62±0.29) mmol/L. Based on the initial venous potassium level, the patients were further divided into three groups. The average potassium decrease in5.5 mmol/L group (4 patients), 5.5-<6.0 mmol/L group (11 patients) and ≥6.0 mmol/L group (6 patients) was (0.46±0.26) mmol/L, (0.62±0.38) mmol/L and (1.04±0.45) mmol/L, respectively. There was statistically significant difference of potassium reduction among the three groups (0.045). Moreover, the extent of potassium reduction was positively correlated with baseline venous potassium level (0.603, 0.004, 21). The study did not reveal any treatment-related adverse event. Sodium zirconium cyclosilicate powder can rapidly and effectively reduce the serum potassium level in chronic kidney disease patients with hyperkalemia.
探讨环硅酸锆钠对慢性肾脏病患者高钾血症紧急纠正的疗效。选取2020年5月至6月在郑州大学第一附属医院肾内科住院的慢性肾脏病患者。最终纳入有高钾血症且服用环硅酸锆钠粉的患者。收集患者的临床资料和实验室检查结果。共纳入21例患者的24份结果。患者年龄为(48.9±13.5)岁。男性14例,女性7例。给药2小时后,静脉血钾水平从(5.85±0.52)mmol/L降至(5.15±0.43)mmol/L(P<0.001,n=21),平均下降(0.71±0.43)mmol/L。同时,动脉血钾水平从(5.50±0.40)mmol/L降至(4.88±0.33)mmol/L(P<0.001,n=10),平均下降(0.62±0.29)mmol/L。根据初始静脉血钾水平,患者进一步分为三组。血钾初始水平为5.5 mmol/L组(4例)、5.5-<6.0 mmol/L组(11例)和≥6.0 mmol/L组(6例)的血钾平均下降幅度分别为(0.46±0.26)mmol/L、(0.62±0.38)mmol/L和(1.04±0.45)mmol/L。三组间血钾下降幅度有统计学差异(P=0.045)。此外,血钾下降幅度与基线静脉血钾水平呈正相关(r=0.603,P=0.004,n=21)。该研究未发现任何与治疗相关的不良事件。环硅酸锆钠粉可快速有效地降低慢性肾脏病高钾血症患者的血清钾水平。