关键词: 肾透析, 透析液, 钾离子浓度, 心律失常, 心源性

Abstract: 0bjective To investigate the effect of dialysate potassium concentration (KD) on predialysis serum potassium and the incidence of hyperkalemia or arrhythmia during hemodialysis．Methods A single-center, open, self-controlled trial was conducted and patients were enrolled according to certain criteria. Predialysis serum potassium was examined when KD=2.0mmol/L (KD 2.0, the following was similar) was still used at one week in May 2010 (0 point). And then KD 2.5 was applied. Predialysis serum potassium was examined in 2, 4, 8, 12 weeks later, respectively. Serious arrhythmic events during hemodialysis were recorded in 12 weeks before and after 0 point．Results 158 patients were enrolled, 2 cases were exit and 156 cases were analyzed. Compared to KD 2.0, KD 2.5 could decrease the incidence of serious arrhythmia during hemodialysis, but the decline had not statistically significant difference (0.78% VS 0.47%，P=0.054)．Predialysis mean serum potassium, incidence of hyperkalemia and severe hyperkalemia were significantly increased in 2 weeks after KD 2.5 applied (4.51±0.79 VS 4.78±0.80 mmol/L, 15.4% VS 26.9%, 3.2% VS 9.6%，P＜0.05, respectively). After intervention for 10 weeks, the incidence of hyperkalemia dropped to the level of 0 point, although predialysis mean serum potassium was still significantly higher. Conclusions Compared to KD 2.0, KD 2.5 had the trends to decrease the incidence of serious arrhythmia during hemodialysis, but increased predialysis hyperkalemia which can be controlled through clinical intervention.

Key words: Renal dialysis, Dialysate, Potassium concentration, Arrhythmia, Cardiac