" urine protein , blood pressure, blood creatinine " are these medical terms. I believe many kidney patients are very familiar with them. Every time they go to the hospital for review, these laboratory items are basically required, but some items may be ignored by patients. I am not familiar with it, but its importance to patients with kidney disease is no less than the above indicators. Sometimes its abnormalities can even endanger the lives of kidney patients, such as blood potassium.
Potassium is the main cation to maintain cell physiological activities. It plays an important role in maintaining the body's normal osmotic pressure and acid-base balance, participating in sugar and protein metabolism, and ensuring the normal function of neuromuscular.
Potassium in the human body mainly comes from food. More than 90% of the potassium in food is absorbed in the intestines in a short time. 90% of the potassium absorbed into the blood is excreted from the kidneys within 4 hours. Most of potassium ion (98%) exists in cells, and a small amount exists in extracellular fluid, and the concentration is constant. tissue cells contain an average of K+150mmol/L, red blood cells contain K+ about 105mmol/L, and serum contains K+ about 4~5mmol/L. Potassium ions in the body are constantly exchanged between cells and body fluids to maintain dynamic balance. The normal range of
potassium:
flame photometer method: 3.5～5.3mmol/L (3.5～5.3mEq/L).
ion selective deelectrode method: 3.9~5.3mmol/L (3.9~5.3mEq/L).
enzyme kinetic method: 3.5～5.1mmol/L (3.5～5.1mEq/L).
When blood potassium exceeds the normal range, it can be diagnosed as hyperkalemia .
Patients with kidney disease often have hyperkalemia due to renal dysfunction and reduced ability to excrete potassium. Especially chronic kidney disease CKD stage 4-5, that is, patients with renal failure and dialysis are more likely to develop hyperkalemia. . Why do patients with
develop hyperkalemia? Common causes of hyperkalemia include excessive intake, reduced excretion, increased intracellular potassium migration, and pseudohyperkalemia. Excessive intake is mainly seen in high-potassium diet, intravenous infusion of large amounts of potassium salt , and transfusion of large amounts of stored blood. Reduced excretion is mainly seen in the oliguric stage of acute and chronic renal failure, and long-term use of potassium-sparing diuretics such as spironolactone and triamterene. agents and distal renal tubular potassium secretion dysfunction, such as systemic lupus erythematosus . Increased intracellular potassium migration is mainly seen in severe hemolysis, large-area burns, and crush syndrome . There is also pseudohyperkalemia, which occurs when the upper arm is compressed too tightly and intermittent fisting produces acidosis during blood drawing, which causes the release of intracellular potassium.
How should patients prevent and treat hyperkalemia? First, they should pay attention to a low-potassium diet and reduce the intake of potassium in food. It is known that fruits or vegetables are relatively high, so you need to reduce the consumption of fruits. Green vegetables need to be cooked before eating. When eating canned fruits and vegetables, remove the liquid from the pulp before eating to reduce the potassium in the vegetables you eat. You can soak the vegetables in warm water without salt for at least two hours, then remove the water and rinse in warm water. Long-term fasting should be avoided, as fasting can increase the transfer of potassium ions to the outside of cells, further increasing blood potassium.
Secondly, if the disease conditions permit, you should try to avoid taking drugs that increase potassium concentration, such as spironolactone or non-selective β-blockers, such as propranolol .
If the patient finds that his blood potassium is high during the examination, he should control it under the guidance of a doctor and monitor his blood potassium regularly. If he feels uncomfortable, he should see a doctor in time.
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