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阳离子交换树脂在高钾血症治疗中的作用。

The role of cation-exchange resins in hyperkalemia management.

作者信息

Tjahjadi Angela Kimberly, Sutanto Henry, Tjempakasari Artaria

机构信息

Resident (Internal Medicine), Faculty of Medicine, Universitas Airlangga, Jl. Prof. Dr. Moestopo No.47, Pacar Kembang, Kec. Tambaksari, Surabaya, Jawa Timur, Indonesia.

Head of Nephrology Division, Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga, Jl. Prof. Dr. Moestopo No.47, Pacar Kembang, Kec. Tambaksari, Surabaya, Jawa Timur, Indonesia.

出版信息

Med J Armed Forces India. 2025 Jan-Feb;81(1):7-14. doi: 10.1016/j.mjafi.2024.07.001. Epub 2024 Aug 16.

Abstract

Hyperkalemia, characterized by elevated serum potassium levels, poses significant health risks, including life-threatening cardiac arrhythmias. The management of hyperkalemia has evolved, incorporating calcium polystyrene sulfonate (CPS) and newer agents such as sodium zirconium cyclosilicate (SZC) and patiromer alongside traditional treatments. This review provides a comprehensive examination of current management strategies for hyperkalemia, focusing on the comparative effectiveness, safety profiles, and patient preferences concerning CPS, SZC, and patiromer. Through an analysis of clinical trials, safety data, and guidelines, we highlight SZC's rapid action and favorable safety profile compared to CPS, which has been a standard treatment option for years. Additionally, the review explores patiromer, other emerging treatments, and future directions in hyperkalemia management, including the potential benefits of combination therapies and the role of personalized medicine. The findings suggest a shift toward newer potassium-binding agents in clinical practice, underscored by the need for individualized treatment approaches based on patient-specific factors. This article aims to guide clinicians in optimizing hyperkalemia management, ensuring effective, safe, and patient-centered care.

摘要

高钾血症以血清钾水平升高为特征,会带来重大健康风险,包括危及生命的心律失常。高钾血症的治疗方法不断演变,除了传统治疗手段外,还纳入了聚苯乙烯磺酸钙(CPS)以及新型药物,如环硅酸锆钠(SZC)和帕替罗姆。本综述全面审视了高钾血症的当前治疗策略,重点关注CPS、SZC和帕替罗姆的比较疗效、安全性概况以及患者偏好。通过对临床试验、安全数据和指南的分析,我们强调与多年来一直作为标准治疗选择的CPS相比,SZC起效迅速且安全性良好。此外,该综述还探讨了帕替罗姆、其他新兴治疗方法以及高钾血症治疗的未来方向,包括联合疗法的潜在益处和个性化医疗的作用。研究结果表明,临床实践正朝着使用新型钾结合剂转变,基于患者特定因素的个体化治疗方法的必要性凸显了这一点。本文旨在指导临床医生优化高钾血症的治疗,确保提供有效、安全且以患者为中心的护理。

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