Costa Davide, Patella Gemma, Provenzano Michele, Ielapi Nicola, Faga Teresa, Zicarelli Mariateresa, Arturi Franco, Coppolino Giuseppe, Bolignano Davide, De Sarro Giovambattista, Bracale Umberto Marcello, De Nicola Luca, Chiodini Paolo, Serra Raffaele, Andreucci Michele
Department of Law, Economics and Sociology, University Magna Graecia of Catanzaro, Catanzaro, Italy.
Renal Unit, Department of Health Sciences, "Magna Graecia" University of Catanzaro, Catanzaro, Italy.
Front Med (Lausanne). 2023 Jul 31;10:1178140. doi: 10.3389/fmed.2023.1178140. eCollection 2023.
Hyperkalemia (HK) is a life-threatening condition that often occurs in patients with chronic kidney disease (CKD). High serum potassium (sKsK) is responsible for a higher risk of end-stage renal disease, arrhythmias and mortality. This risk increases in patients that discontinue cardio-nephroprotective renin-angiotensin-aldosterone system inhibitor (RAASi) therapy after developing HK. Hence, the management of HK deserves the attention of the clinician in order to optimize the therapeutic strategies of chronic treatment of HK in the CKD patient. The adoption in clinical practice of the new hypokalaemic agents patiromer and sodium zirconium cyclosilicate (SZC) for the prevention and chronic treatment of HK could allow patients, suffering from heart failure and chronic renal failure, to continue to benefit from RAASi therapy. We have updated a narrative review of the clear variables, correct definition, epidemiology, pathogenesis, etiology and classifications for HK among non-dialysis CKD (ND CKD) patients. Furthermore, by describing the prognostic impact on mortality and on the progression of renal damage, we want to outline the strategies currently available for the control of potassium (K+) plasma levels.
高钾血症（HK）是一种危及生命的病症，常发生于慢性肾脏病（CKD）患者中。高血清钾（sK）会导致终末期肾病、心律失常和死亡风险升高。在发生HK后停用心脏肾保护肾素-血管紧张素-醛固酮系统抑制剂（RAASi）治疗的患者中，这种风险会增加。因此，HK的管理值得临床医生关注，以便优化CKD患者HK慢性治疗的策略。新型低钾血症药物帕替罗姆和环硅酸锆钠（SZC）在临床实践中用于HK的预防和慢性治疗，这可能使患有心力衰竭和慢性肾衰竭的患者继续从RAASi治疗中获益。我们更新了一篇叙述性综述，内容涉及非透析CKD（ND CKD）患者HK的明确变量、正确定义、流行病学、发病机制、病因和分类。此外，通过描述对死亡率和肾损害进展的预后影响，我们想概述目前控制血浆钾（K+）水平的可用策略。
