Hyperkalemia inoratidzwa kana iyo serum potassium yako inokera 5.0 mEq / L kana kupfuura. Inogona kukonzerwa nokudiridza potassium yakawandisa, kwete kuwedzera zvakakwana potassium, kana kuti ne potassium ichibuda kunze kwemasero.
Kuedza kunogona kubatsira kuziva kuti ndeipi yenzira idzi dzinokonzera potassium yako yakakwirira. Chero kana iwe uchiziva chikonzero nei une hyperkalemia iwe unogona kuchibata zvakanaka uye uchivimba kudzivirira kudzokorora.
Dambudziko reRopa
Usati wadzika mugwara rekuongorora, chiremba wako achada kuve nechokwadi kuti une hyperkalemia yechokwadi. Kazhinji, pasiziyamu mazinga anonyengera, iyo inonzi pseudohyperkalemia, nekuda kwekuti ropa rako rinoswededzwa sei .
Kushanyirwa kunoshandiswa zvakasimba zvakasimba kana kure kure kunogona kukonzera masero matsvuku eropa kuti aite hemolyze kana kuputika, iyo inokonzera potasium mumuenzaniso. Kudzokorora kwepfumo panguva yekuputika kunogona kukonzera potasium kuti ibude mumasero ako, kuwedzera mazamu ebasa rako kusvika 1 kusvika 2 mEq / L.
Basa rekutanga rechiremba wako nderekuchechedza potassium yako yepamusoro. Kana mazamu ako akaramba ari akakwirira, chiremba wako anogona kuraira zviyero zvinotevera.
Initial Tests
Renal failure , ingave yakaoma kana isingaperi, ndeimwe yezvinowanzokonzera hyperkalemia. Apo itsvo dzinokundikana, hazvikwanisi kuisa phosasium zvakanaka. Izvi zvinogona kutungamirira pakuvaka-up of potassium muropa.
Ropa urea nitrogen (BUN) uye creatinine kuenzanisa kuti mafungiro ako ari kushanda zvakadini uye anowanikwa sechikamu chegadzirirwo remagetsi kagumi. Mimwe miedzo iri mubato rinosanganisira sodium, chloride, bicarbonate, uye glucose. Aya maitiro ehutano anoshandiswa kuverenga nhengo yei anion iyo, kana yakakwirira, inoratidzira metabolic acidosis.
Acidosis inogona kutora potassium kunze kwemasero uye muropa. Kukwidzika kwemashuga, sezvinogona kuonekwa mukushushikana kwechirwere cheshuga , zvinogona kuita zvakafanana. Low sodium levels mukutarisana nepamusoro pepamasiyamu mazinga inogona kuratidza humo hwemhomoni inonzi hypoaldosteronism.
Ropa rakazara rinogona kuvewo rinobatsira kuongorora kuongorora. Ropa rega rega rinogona kuva chiratidzo chekutapukirwa kana kuputika mumuviri. Low hemoglobin uye hematocrit mazinga anemia. Chirwere chepamuviri chinokonzerwa nokuparara kwemasero matsvuku eropa, anonziwo hemolytic anemia , anogona kusunungura mapazi epamusoro muropa.
- BUN
- Creatinine
- Metabolic panel
- Kuzara ropa kuverenga
Miedzo yakananga
Zvichienderana nezviratidzo zvako uye nhoroondo yezvokurapa, chiremba wako angasarudzawo kutevera zvimwe zvezviedzo zvinotevera.
- Aldosterone: Aldosterone ihomoni inokonzerwa nedrenal gland inodzora ropa. Kunyange kana potassium yepamusoro uye mazinga e-sodium ari pasi, aldosterone level inofanirwa kusimbisa kuongororwa kwe hypoaldosteronism. Kunyengedzera kunowanzoonekwawo nemamiriro ezvinhu.
- Creatinine phosphokinase (CPK): High levels of CPK inoratidza kuti pane kuve nekukuvara kumisungo. Hakusi chete iyo enzyme inodonha kubva mumatumbu asi inogona kuwedzera mafungiro, zvichiita kuti kushaya kusvitsa mune izvo zvinonzi rhabdomyolysis . Potassium inodonhawo kubva mumashuga emuviri.
- Digoxin mazinga: Digoxin ndeimwe yemishonga yakawanda inogona kuva nemigumisiro yechirwere chema hyperkalemia. Kusiyana ne beta-blockers iyo inogonawo kuwedzera serum potassium, digoxin ine kuongorora ropa kuti uone kuti mushonga wakawanda uri muropa rako.
- Uric acid uye kuongorora phosphorus: Apo masero anopera, anosunungura uric acid uye phosphorus pamwe ne potassium. Izvi zvinogona kuitika mu hemolytic anemia kana chirwere-ups che sickle cell chirwere. Inogonawo kuitika mu tumor lysis syndrome apo pane kuora kukuru kwemasero mushure memakemikari.
Urine Miedzo
Kushandura kwemaitiro okutsvaga kunotarisa ropa, glucose, mapuroteni, kana utachiona mumurini.
Zvisina kuwanikwa zvinogona kuratidza glomerulonephritis, kuputika kwepvo, kana glomerulonephrosis, chirwere chisina kuvhiringidza apo mafungiro anoputika maprotheni. Inogonawo kuratidza chirwere cheshuga chisingadzorwi.
Mimwe miedzo yakanyanyisa yerino inogona kutevedzwa kuti uone kuti mafungiro ari kuita sei. Kana kuvhara kwemuti we potassium uye sodium zviri mumiganhu inotarisirwa, itsvo haisi mhosva. Chikonzero chisingaiti chetsva chinofanira kuongororwa. Kuedzwa kwemuyoglobin urine kunogona kusimbisa kuongororwa kwerhabdomyolysis.
- Basic urinalysis
- Urine potassium uye sodium
- Urine myoglobin
Matambudziko emwoyo
Hyperkalemia inogona kukonzera zvirongedzo zvehupenyu zvinotyisa kana potassium yako mazinga ichikwirira. An electrocardiogram (ECG) chinhu chinokosha chekuongorora chirwere, kwete kungoona matambudziko makuru e hyperkalemia asiwo kuziva kuti rudzi rwemagetsi ruripi.
IEECG inoyera kutengesa magetsi kuburikidza nemwoyo, kubva kumakamuri makuru emoyo, maatria, kumakamuri epasi, mavhiriki. Mutsetse wega wega weEECG kubva paPQRST unomiririra kushanda kana kugadzirisa imwe kamuri yemukati wemwoyo.
Sezvo sarum potassium inowedzera, ECG inochinja yakaoma. Kutanga pazvikamu zve55 meq / L uye pamusoro, zvinyorwa zvinogona kunge zvakaoma kuwanazve. Izvi zvinogona kuonekwa semafungiro e-ECG. Atrial activation inogadziriswa pa 6.5 mEq / L kuitira kuti p-mazai asazoonekwazve. Pakusvika 7.0 mEq / L, mazai eQRS akawedzerwa, achienderana nekunonoka kushandiswa kwemhepo.
Cardiac arrhythmias inowanzokura pa 8.0 mEq / L. Izvi zvinogona kusanganisira zvose kubva ku sinus bradycardia kune ventricular tachycardia . Mumamiriro ezvinhu akaipisisa, asystole, kurasikirwa kwemagetsi ose emagetsi, zvinogona kuitika. Kunyange zvazvo ECG isingazivi kuti chii chinokonzera hyperkalemia, inoratidza kuoma kwemamiriro acho ezvinhu. Cardiac arrhythmias inoda kurapwa mushonga.
Kusiyanisa Kuziva
Vanhu vane cirrhosis, congestive mwoyo kusakundikana , uye chirwere cheshuga chiri pangozi yakakura yekukura hyperkalemia. Zvimwe zvirwere zvisingaperi zvinogona kuva chinhu chinosanganisira amyloidosis uye sickle cell chirwere .
Kana iwe wakanyorerwa mishonga seACE inhibitors, angiotensin-receptor blockers, beta-blockers , cyclosporine, digoxin, minoxidil, spironolactone, uye tacrolimus, zive kuti potassium yako inogona kuwedzera. Chiremba wako angatarisa zvimwe zvinokonzera hyperkalemia, sekukundikana kwechirwere uye hypoaldosteronism, sezvataurwa pamusoro apa.
> Sources:
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> Levis JT. ECG Kuziva: Hyperkalemia. Perm J. 2013 Winter; 17 (1): 69.doi: 10.7812 / TPP / 12-088
> Lewis JL. Hyperkalemia. Merck Manual: Professional Version. Yakavandudzwa April 2016. https://www.merckmanuals.com/professional/endocrine-and-metabolic-disorders/electrolyte-disorders/hyperkalemia.
> Gomo DB. Zvinokonzera nekuongorora kweHyperkalemia muVakuru. Mu: Forman JP (ed), UpToDate [Internet] , Waltham, MA. Yakavandudzwa February 2018.
> Simon LV, Farrell MW. Hyperkalemia. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. 2018 Jan-.