维持性血液透析患者血液透析前后的血钾波动  

Blood potassium fluctuations before and after dialysis in maintenance hemodialysis patients

作　　者：杨海燕 陈玲 代博 刘霞 孙尚萍 Yang Haiyan;Chen Ling;Dai Bo;Liu Xia;Sun Shangping(Department of Nephrology and Rheumatology,Zunyi Hospital of Traditional Chinese Medicine,Zunyi 563000,China)

机构地区：[1]遵义市中医院肾病风湿科,贵州遵义563000

出　　处：《临床荟萃》2024年第9期798-802,共5页Clinical Focus

摘　　要：目的观察维持性血液透析(maintenance hemodialysis,MHD)患者血液透析(透析)前后的血钾波动。方法纳入2021年2月至2023年2月就诊于遵义市中医院肾病风湿科的MHD患者42例,采用中位数分组法分为Δ血钾(透析前后血钾差值)≥1.44 mmol/L组(n=21)和Δ血钾<1.44 mmol/L组(n=21),比较两组临床资料的差异。结果两组年龄、性别、URR、sp Kt/V、HD模式差异均无统计学意义(P>0.05);与Δ血钾<1.44 mmol/L组比较,Δ血钾≥1.44 mmol/L组基础病为非糖尿病肾病占比较大(P=0.019)、透析前血钾水平更高(P<0.001)。偏相关分析显示,在校正年龄后,Δ血钾仍与透析前后血钾呈正相关,且Δ血钾与透析前血钾的正相关性更为显著(P<0.05)。结论基础病为非糖尿病肾病和透析前血钾高水平与MHD患者透析前后血钾波动较大相关,临床应引起重视。Objective To observe the fluctuations of serum potassium in maintenance hemodialysis(MHD)patients before and after hemodialysis.Methods A total of 42 MHD patients admitted in the Nephrology and Rheumatology Department of Zunyi Hospital of Traditional Chinese Medicine from February 2021 to February 2023 were selected.According to the median grouping method,patients were divided intoΔserum potassium(difference of serum potassium before and after dialysis)≥1.44 mmol/L group(n=21)andΔserum potassium<1.44 mmol/L group(n=21).Clinical data between the two groups were compared.Results There were no significant differences in the age,gender,urea reduction ratio(URR),single-pool urea Kt/V(sp Kt/V)and hemodialysis(HD)mode between the two groups(P>0.05).Compared with theΔserum potassium<1.44 mmol/L group,the proportion of non-diabetic nephropathy(P=0.019)and serum potassium before dialysis were significantly higher in theΔserum potassium≥1.44 mmol/L group(P<0.001).Partial correlation analysis showed that after adjusting for age,Δserum potassium was positively correlated with serum potassium before and after dialysis,and the positive correlation betweenΔserum potassium and serum potassium before dialysis was more significant(P<0.05).Conclusion Non-diabetic nephropathy as the comorbidity and the high-level serum potassium before MHD is related to the large fluctuation of serum potassium before and after MHD,which should be paid attention to in clinical practice.

关 键 词：维持性血液透析 血钾波动 影响因素 

分 类 号：R459.5[医药卫生—治疗学]