Effect of varying doses of potassium-magnesium citrate on thiazide-induced hypokalemia and magnesium loss.
Effect of varying doses of potassium-magnesium citrate on thiazide-induced hypokalemia and magnesium loss.
复制标题
不同剂量的柠檬酸钾镁对噻嗪类引起的低钾血症和镁损失的影响。
DOI：
10.1097/00045391-199901000-00007
复制
发表时间：
1999
期刊：
影响因子：
--
通讯作者：
Pak,CY
中科院分区：
文献类型：
--
作者：
Ruml,LA;Gonzalez,G;Taylor,R;Wuermser,LA;Pak,CY
本研究的目的是比较三种剂量的柠檬酸钾镁在克服噻嗪类药物引起的低钾血症和镁流失以及增加尿pH和柠檬酸盐的疗效。61名正常人首次服用氢氯噻嗪50 mg/d。噻嗪类治疗后3周或更早如果低钾血发达,受试者被随机分配的三种剂量potassium-magnesium柠檬酸(K 4 MgCit 2) 3周,同时继续噻嗪类:4片/天(24毫克当量钾、12毫克当量镁和柠檬酸36毫克当量/天),每天7平板电脑(49毫克当量钾、24.5毫克当量镁、柠檬酸和73.5毫克当量/天),每天或10片(70毫克当量钾、35毫克当量镁、柠檬酸和105毫克当量/天)。结果测量血清钾、镁、尿钾、镁、pH和柠檬酸盐的变化。三种剂量的柠檬酸钾镁均可显著增加血清钾浓度，尽管继续使用噻嗪类药物，但仍有80%的受试者恢复了正常值。两种较高剂量，而不是最低剂量，导致血清镁浓度小幅但显著升高，而尿镁显著升高。所有三种剂量均以剂量依赖性方式显著增加尿pH值和柠檬酸盐。产生的最低剂量增加到足以防止结石复发。最高剂量可改善噻嗪治疗的副作用，但两种较低剂量不能改善。每天服用4片柠檬酸钾镁足以纠正噻嗪类药物引起的低钾血症，并足以增加尿液pH值和柠檬酸，以预防结石。可能需要更高的剂量来预防镁的流失和噻嗪治疗的不良症状。
The purpose of this study was to compare the efficacy of three dosages of potassium-magnesium citrate in overcoming thiazide-induced hypokalemia and magnesium loss and increasing urinary pH and citrate. Sixty-one normal subjects first took hydrochlorothiazide at 50 mg/d. After 3 weeks of thiazide treatment or earlier if hypokalemia developed, the subjects were randomized to take one of three dosages of potassium-magnesium citrate (K 4 MgCit 2) for 3 weeks while continuing on the thiazide: 4 tablets per day (24 mEq potassium, 12 mEq magnesium, and 36 mEq citrate per day), 7 tablets per day (49 mEq potassium, 24.5 mEq magnesium, and 73.5 mEq citrate per day), or 10 tablets per day (70 mEq potassium, 35 mEq magnesium, and 105 mEq citrate per day). Outcome measures were changes in serum potassium and magnesium and urinary potassium, magnesium, pH, and citrate. All three dosages of potassium-magnesium citrate significantly increased serum potassium concentration, with> 80% of subjects regaining normal values despite continued thiazide therapy. The two higher dosages, but not the lowest dosage, caused a small but significant increase in serum magnesium concentration, while substantially increasing urinary magnesium. All three dosages significantly increased urinary pH and citrate in a dose-dependent manner. The lowest dosage produced increases sufficient to prevent stone recurrence. Side effects of thiazide therapy were ameliorated by the highest dosage but not by the two lower dosages. Potassium-magnesium citrate at a dosage of 4 tablets per day is adequate to correct thiazide-induced hypokalemia and to increase urinary pH and citrate sufficiently for stone prevention. Higher dosages are probably required for the prevention of magnesium loss and adverse symptoms of thiazide therapy.