中国血液净化

中国血液净化 ›› 2023, Vol. 22 ›› Issue (09): 695-697.doi: 10.3969/j.issn.1671-4091.2023.09.013

• 综述 • 上一篇    下一篇

血液透析患者血钾波动对预后的影响

布仁其其格     刘 莉     陈尔冬     陈育青   

  1. 100034 北京，北京大学第一医院1肾内科 北京大学肾脏疾病研究所 卫生部肾脏疾病重点实验室 慢性肾脏病防治教育部重点实验室(北京大学)  2心血管内科
  • 收稿日期:2023-06-07 修回日期:2023-07-04 出版日期:2023-09-12 发布日期:2023-09-12
  • 通讯作者: 刘莉 E-mail:cutewise@163.com
  • 基金资助:
    北京大学第一医院院内交叉临床研究专项(2022CR08)

Effect of hyperkalemia on electrocardiographic stability of hemodialysis patients

Burenqiqige, LIU Li, CHEN Er-dong, CHEN Yu-qing   

  1. Renal Division, Department of Medicine, Peking University First Hospital; Institute of Nephrology, Peking University; Key Laboratory of Renal Disease, Ministry of Health of China; Key Laboratory of Chronic Kidney Disease Prevention and Treatment, Ministry of Education, Beijing, 100034 China; 2Cardiovascular Division, Peking University First Hospital, Beijing, 100034, China
  • Received:2023-06-07 Revised:2023-07-04 Online:2023-09-12 Published:2023-09-12
  • Contact: 100034 北京，北京大学第一医院1肾内科 E-mail:cutewise@163.com

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摘要： 高钾血症(hyperkalemia)是维持性血液透析(maintenance hemodialysis,MHD)患者较为常见的并发症。当血钾浓度升高时不仅改变细胞内外的钾浓度梯度差进而打破心肌细胞的电稳定性，还会促进透析过程中钾离子在血清-透析液间以及细胞内外的大量且快速地移位，这些因素均可能增加MHD患者心律失常的发生风险。因此及时治疗高钾血症并且选择最佳的透析液钾处方至关重要。本综述主要讨论了高钾血症以及透析治疗对于血液透析患者心电稳定性的影响和相关的处理措施。

关键词: 维持性血液透析, 高钾血症, 心电稳定性

Abstract: Hyperkalemia is a common complication of maintenance hemodialysis (MHD) patients. When blood potassium concentration increases, it will not only change the gradient of potassium concentration inside and outside the cells and break the electrical stability of myocardial cells, but will also promote massive and rapid shift of potassium ions between serum and dialysate and inside and outside the cells during dialysis. These factors may increase the risk of arrhythmia in MHD patients. Therefore, it is very important to treat hyperkalemia in time and choose the best potassium prescription of dialysate. This review discusses the influence of hyperkalemia and dialysis treatment on electrocardiographic stability of hemodialysis patients and related treatment measures.

Key words: Maintenance hemodialysis, Hyperkalemia, Electrocardiographic stability

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