【摘要】终末期肾病(end stage renal disease,ESRD)维持性血液透析患者具有较高的高血钾发生率，且随着肾功能恶化,高钾血症的复发风险逐渐升高。包括透析不当、同时使用升高血钾的药物以及合并某些疾病等许多因素均增加透析患者发生高钾血症风险。透析患者发生高钾血症与其不良预后密切相关，不仅增加患者死亡风险，而且增加急诊就诊和住院次数以及医疗成本。因此，对于ESRD 血液透析反复发生高血钾患者应重视对血钾水平的综合管理，包括对高钾饮食的限制、充分的透析治疗、避免应用升高血钾的药物以及合理使用降钾药物等。
【Abstract】Patients with end-stage renal disease (ESRD) on maintenance hemodialysis have a high incidence of hyperkalemia, and with the deterioration of renal function, the risk of recurrence of hyperkalemia gradually increases. Many factors, including inappropriate dialysis, concomitant use of drugs that raise serum potassium, and certain medical conditions, increase the risk of hyperkalemia in dialysis patients. Hyperkalemia in dialysis patients is closely related to its poor prognosis, not only increasing the risk of death, but also increasing the number of emergency department visits and hospitalizations, and medical costs. Therefore, for HD patients with recurrent hyperkalemia, attention should be paid to the comprehensive management of serum potassium levels, including restriction of high potassium diet, adequate dialysis treatment, avoidance of drugs that increase serum potassium, and rational use of potassium-lowering drugs.
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