Dialysate potassium concentration: Should mass balance trump electrophysiology?
Dialysate potassium concentration: Should mass balance trump electrophysiology?
复制标题
透析液钾浓度：质量平衡应该胜过电生理学吗？
DOI：
10.1111/sdi.12738
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发表时间：
2018
影响因子：
1.6
通讯作者：
Pun,PatrickH
中科院分区：
文献类型：
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作者：
Pun,PatrickH
肾科医师在选择理想的透析处方以维持中性钾质量平衡时面临着困难的困境。钾质量平衡目标是否应优先考虑使用低钾透析液使血清钾水平正常化，以引起透析中心律失常为代价，或者质量平衡目标是否应支持使用较高透析液钾的允许性高钾血症，以避免透析中快速通量，从而增加透析间心律失常的风险？本综述检查了决定血液透析患者钾质量平衡的因素，血清和透析液钾水平与结局之间的关系，并通过检查目前可用的方法来降低心律失常风险，同时管理钾质量平衡得出结论。
Nephrologists are faced with a difficult dilemma in choosing the ideal dialysis prescription to maintain neutral potassium mass balance. Should potassium mass balance goals prioritize the normalization of serum potassium levels using low potassium dialysate at the expense of provoking intradialytic arrhythmias, or should mass balance goals favor permissive hyperkalemia using higher dialysate potassium to avoid rapid intradialytic fluxes at the risk of more interdialytic arrhythmias? This review examines the factors that determine potassium mass balance among HD patients, the relationships between serum and dialysate potassium levels and outcomes, and concludes by examining currently available approaches to reducing risk of arrhythmias while managing potassium mass balance.