评估钾排泄紊乱的新临床方法。

New clinical approach to evaluate disorders of potassium excretion.

作者信息

West M L, Marsden P A, Richardson R M, Zettle R M, Halperin M L

出版信息

Miner Electrolyte Metab. 1986;12(4):234-8.

Abstract

A new clinical approach to patients with disorders of potassium excretion is reported. This approach uses a urinary index, the ratio of potassium concentrations in the urine to vein after adjusting the urine potassium concentration for medullary water abstraction. This index provides a semiquantitative assessment of the apparent transtubular potassium concentration gradient (TTKG) in the major distal nephron segment where potassium is secreted. Three clinical situations are presented where the use of this index provided a better indication of the renal action of mineralocorticoids than did the traditional approach; in each case, the presence of mineralocorticoids was known as drugs with this action were administered. We emphasize that use of this index is restricted to situations where the urine is not hypotonic and distal nephron sodium delivery is not limiting for potassium secretion (greater than 25 mM, twice the sodium concentration required for maximum potassium transport at this nephron site).

摘要

报告了一种针对钾排泄紊乱患者的新临床方法。该方法使用一种尿指标，即经髓质水重吸收调整后的尿钾浓度与静脉钾浓度之比。该指标可对钾分泌的主要远端肾单位节段的表观跨肾小管钾浓度梯度（TTKG）进行半定量评估。文中介绍了三种临床情况，在这些情况下，使用该指标比传统方法能更好地指示盐皮质激素的肾脏作用；在每种情况下，由于使用了具有这种作用的药物，盐皮质激素的存在是已知的。我们强调，该指标的使用仅限于尿液非低渗且远端肾单位钠输送不限制钾分泌的情况（大于25 mM，是该肾单位部位最大钾转运所需钠浓度的两倍）。