确定高钾血症的当前原因,以及它们在过去25年中是否发生了变化。

IF 1.1 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Acta Clinica Belgica Pub Date : 2014-08-01 Epub Date: 2014-06-18 DOI:10.1179/0001551214Z.00000000077
X Muschart, C Boulouffe, J Jamart, G Nougon, V Gérard, L de Cannière, D Vanpee
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引用次数: 13

摘要

目的:高钾血症是一种潜在的致死性电解质紊乱。本研究的目的是确定25年来急诊(ED)高钾血症相关就诊的原因是否发生了变化。方法:2009年1月至2011年8月期间,所有因高钾血症就诊于急诊科的患者均纳入本回顾性单中心研究。结果:共纳入139例高钾血症患者(平均K(+)为6.2 mEq/l),其中35%为轻度高钾血症,49%为中度高钾血症,16%为重度高钾血症。83%的患者(n = 115)患有肌酐水平≥1.25 mg/dl或估计肾小球滤过率(eGFR)水平≤60 ml/min/ 1.73 m的RF(2)。血清钾水平与肌酐和eGFR值显著相关(结论:RF(83%)和PIDs(75%)仍然是高钾血症的常见原因。高钾血症与四个变量显著相关:肌酐水平、螺内酯、乙酰胆碱抑制剂和受体阻滞剂摄入量。高钾血症的病因近年来没有改变。
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A determination of the current causes of hyperkalaemia and whether they have changed over the past 25 years.

Objective: Hyperkalaemia is a potentially lethal electrolyte disorder. The objective of this study was to determine if the causes of hyperkalaemia-related visits to the emergency department (ED) have changed since 25 years.

Methods: All patients presenting to the ED with hyperkalaemia between January 2009 and August 2011 were included in this retrospective, single-centre study. Patients were divided into one of these three categories: mild (5·2≤ K(+)<5·8 mEq/l), moderate (5·8≤K(+)<7·0 mEq/l) or severe hyperkalaemia (K(+)≥7·0 mEq/l). The causes of hyperkalaemia were divided into three groups: renal failure (RF), potassium-increasing drugs (PIDs) or others.

Results: Overall, 139 patients with hyperkalaemia were included in the study (mean K(+) of 6·2 mEq/l): 35% with mild, 49% with moderate and 16% with severe hyperkalaemia. Eighty-three per cent of patients (n = 115) had RF with creatinine levels ≥1·25 mg/dl or estimated glomerular filtration rate (eGFR) levels ≤60 ml/min/1·73 m(2). Serum potassium levels were significantly related with creatinine and eGFR values (P<0·001). The severity of hyperkalaemia was significantly related with creatinine levels ≥1·25 mg/dl (P = 0·002) and eGFR values ≤60 ml/min/1·73 m(2) (P = 0·005). Seventy-five per cent of patients (n = 105) were taking PIDs. Potassium levels were significantly related with PIDs (P<0·001), in particularly spironolactone (P = 0·001) and angiotensin-converting enzyme inhibitors (P = 0·008). The category 'others' included 7% of patients (n = 10).

Conclusions: RF (83%) and PIDs (75%) remain common causes of hyperkalaemia. Hyperkalaemia is significantly related with four variables: creatinine levels, spironolactone, ACEIs and beta-blocker intake. The causes of hyperkalaemia have not changed in recent years.

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来源期刊
Acta Clinica Belgica
Acta Clinica Belgica MEDICINE, GENERAL & INTERNAL-
CiteScore
3.50
自引率
0.00%
发文量
44
期刊介绍: Acta Clinica Belgica: International Journal of Clinical and Laboratory Medicine primarily publishes papers on clinical medicine, clinical chemistry, pathology and molecular biology, provided they describe results which contribute to our understanding of clinical problems or describe new methods applicable to clinical investigation. Readership includes physicians, pathologists, pharmacists and physicians working in non-academic and academic hospitals, practicing internal medicine and its subspecialties.
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