Potassium: friend or foe?
Potassium: friend or foe?
复制标题
DOI：
10.1007/s00467-016-3411-8
复制
发表时间：
2017-07
期刊：
影响因子：
--
通讯作者：
Rodan AR
中科院分区：
文献类型：
--
作者：
Rodan AR
肾脏在维持血液离子浓度的动态平衡方面起着至关重要的作用。由于细胞膜上钾的浓度梯度是细胞膜电位的关键决定因素，即使血钾与正常设定值的微小偏差也可能导致严重的肌肉功能障碍，导致呼吸衰竭和心脏骤停。不太严重的低钾和高钾血症也与不同患者群体的发病率和死亡率有关。此外，钾摄入量不足与高血压以及心血管和肾脏的不良后果有关。这可能部分归因于肾脏对钠和钾的相互关联的处理。在这里，将回顾有关钾对血压、心血管和肾脏结果的有益影响的数据，以及这些影响的生理基础。然而，在一些患者群体中，钾过量是有害的。将回顾导致高钾血症的危险因素，以及现有和新出现的治疗高钾血症的方法的风险和益处。
The kidney plays an essential role in maintaining homeostasis of blood ion concentrations. Because the concentration gradient of potassium across the cell membrane is a key determinant of the membrane potential of cells, even small deviations in serum potassium from the normal setpoint can lead to severe muscle dysfunction, resulting in respiratory failure and cardiac arrest. Less severe hypo- and hyperkalemia are also associated with morbidity and mortality across various patient populations. In addition, deficiencies in potassium intake have been associated with hypertension and adverse cardiovascular and renal outcomes. This is likely due in part to the interrelated handling of sodium and potassium by the kidney. Here, data on the beneficial effects of potassium on blood pressure and cardiovascular and renal outcomes will be reviewed, along with the physiological basis for these effects. In some patient populations, however, potassium excess is deleterious. Risk factors for the development of hyperkalemia will be reviewed, as well as the risks and benefits of existing and emerging therapies for hyperkalemia.