Hyperkalemia in Predialysis Patients

[摘要] Potassium homeostasis is generally well maintained in patients with advanced CKD until the GFR falls below 10–15 ml/min. Loss of nephron mass is counterbalanced by an adaptive increase in the secretory rate of K+ in remaining nephrons, such that fractional excretion of K+ is increased. In a study of normokalemic patients with stage 4 CKD, the fractional excretion of K+ was 126% compared with 26% in normal controls (1). Intravenous administration of amiloride decreased the fractional excretion by 87% in CKD patients compared with a fall of only 19.5% in controls, suggesting amiloride-sensitive renal K+ secretion is an important adaptive mechanism in the maintenance of normal K+ homeostasis in these patients.

[学科分类] 泌尿医学

[关键词] Bone marrow necrosis;Sickle cell disease;Hyperhemolysis syndrome