慢性肾脏病中高钾血症的治疗进展  

Progress in Treatment of Hyperkalemia in Chronic Kidney Disease

作　　者：郝慧芳[1] 李青[1] 张秋平 李伟 HAO Huifang;LI Qing;ZHANG Qiuping;LI Wei(Department of Nephrology,Tianjin TEDA Hospital,Tianjin 300457,China)

机构地区：[1]天津市泰达医院肾内科,天津300457

出　　处：《医学综述》2021年第15期3050-3054,共5页Medical Recapitulate

摘　　要：高钾血症是临床常见的电解质紊乱,尤其多见于慢性肾脏病(CKD)患者,是CKD的主要并发症之一,严重时可危及患者生命。随着CKD患病率的升高,高钾血症的有效防治越来越重要。目前治疗高钾血症的药物多用于急性高钾血症的短期控制,不适用于长期维持治疗,而新型降钾药物(如环硅酸锆钠)可以安全有效地防治高钾血症。肾素-血管紧张素-醛固酮系统抑制剂对心、肾均有有益作用,但常因导致高钾血症而停用,与新型降钾药物联用可减少高钾血症发生。新型降钾药物为肾素-血管紧张素-醛固酮系统抑制剂在CKD患者中继续应用提供了可能。Hyperkalemia is a common clinical electrolyte disorder,especially more commonly seen in patients with chronic kidney disease(CKD).It is one of the main complications of CKD and can be life-threatening in severe cases.With the increasing prevalence of CKD,effective prevention and treatment of hyperkalemia is becoming more and more important.At present,the drugs for hyperkalemia are mostly used for short-term control of acute hyperkalemia,which not suitable for long-term use,and new potassium-lowering drugs such as sodium zirconium cyclosilicate can prevent and treat hyperkalemia safely and effectively.Renin-angiotensin-aldosterone system inhibitors have beneficial effects on both the heart and kidneys,but they are often discontinued due to hyperkalemia,and when combined with new potassium-lowering drugs the occurrence of hyperkalemia can be reduced.New potassium-lowering drugs provide the possibility for the continued use of renin-angiotensin-aldosterone system inhibitors in the CKD patients.

关 键 词：高钾血症 慢性肾脏病 肾素-血管紧张素-醛固酮系统阻断剂 K+结合剂 环硅酸锆钠 

分 类 号：R589.4[医药卫生—内分泌]