Department of Nephrology and Dialysis, Medical University Vienna, Austria.
Department of Internal and Emergency Medicine, Buergerspital Solothurn, Switzerland.
Swiss Med Wkly. 2020 Nov 12;150:w20366. doi: 10.4414/smw.2020.20366. eCollection 2020 Oct 19.
Acid base and electrolyte disorders are frequently reported in the early period after renal transplantation. No comprehensive data exist on the prevalence and patterns of, and contributing factors to, electrolyte disturbances in patients with stable long-term allograft function.
We analysed 576 renal transplant recipients (serum creatinine level <2.0 mg/dl) in a cross-sectional study to evaluate the prevalence of electrolyte disorders and the risk factors associated with their occurrence.
A total of 369 patients (64%) of all allograft recipients (n = 576) showed at least one electrolyte and acid base disorder. The most abundant disorder was hypomagnesaemia (25%, n = 143), followed by hyperkalaemia (12.8%, n = 74), hypercalcaemia (12%, n = 69), hypophosphataemia (11.6%, n = 67), metabolic acidosis (11.1%, n = 61) and hyponatraemia (9%, n = 52). All other electrolyte disorders were rare (<6%). In most cases the electrolyte disorders could be classified as mild. Forty percent of the cases had a combined disorder, but without a preferential pattern of combinations. In a multivariate logistic regression analysis, the most important factors contributing significantly to the occurrence of electrolyte disorders were renal function and concomitant medications.
Acid base and electrolyte disorders are frequently observed in stable renal allograft recipients, but are usually mild. A combination of two or more electrolyte abnormalities often occurs, although no predominant pattern of a unique combination of electrolyte disorder is recognizable.  .
酸堿和电解质紊乱在肾移植后早期经常发生。在稳定的长期同种异体肾功能患者中,电解质紊乱的患病率、模式和相关因素尚无综合数据。
我们对 576 例(血清肌酐水平 <2.0 mg/dl)肾移植受者进行了横断面研究,以评估电解质紊乱的患病率以及与电解质紊乱发生相关的危险因素。
所有同种异体受者(n = 576)中共有 369 例(64%)出现至少一种电解质和酸堿紊乱。最常见的紊乱是低镁血症(25%,n = 143),其次是高钾血症(12.8%,n = 74)、高钙血症(12%,n = 69)、低磷血症(11.6%,n = 67)、代谢性酸中毒(11.1%,n = 61)和低钠血症(9%,n = 52)。其他所有电解质紊乱均罕见(<6%)。在大多数情况下,电解质紊乱可分类为轻度。40%的病例存在合并症,但没有优先的合并症模式。在多变量逻辑回归分析中,对电解质紊乱发生有显著贡献的最重要因素是肾功能和伴随药物。
稳定的肾移植受者经常出现酸堿和电解质紊乱,但通常为轻度。两种或更多电解质异常的组合经常发生,尽管没有可识别的特定电解质紊乱组合的优势模式。