I-New Patiromer yezidakamizwa ibonisa isithembiso ekuphatheni i-Hyperkalemia
Isidakamizwa esisha okuthiwa i-Patiromer sibonise isithembiso ekuphatheni i-hyperkalemia kubantu abathatha ama-inhibitors (renin-angiotensin-aldosterone system). I-Hyperkalemia isongela ukuphila futhi ibangele ubuthakathaka, ikhuphuke ukukhubazeka, ukwehluleka ukuphefumula, nokukhubazeka kwenhliziyo.
Ngezinye izikhathi, abantu abakhona nge-hyperkalemia, noma amazinga aphakeme e-potassium egazini, emitholampilo yokugula.
Laba bantu basebekhulile futhi ngokuvamile banesifo sikashukela soshukela futhi bahlinzekwa nge-hyperkalemia ngemuva kokuthatha uhlelo lwe-renin-angiotensin-aldosterone (RAAS) inhibitors (i-β-blockers, i-enzyme inhibitors, i-angiotensin receptor blockers [ARBs] kanye ne-aldosterone receptor antagonists) Kulezi ziguli ezinokukhubazeka okuyisigqila noma isifo sokuphefumula kwesifo sikashukela, amazinga e-potassium angakhuphuka abe amazinga anobungozi ngemuva kokuphathwa kwe-RAAS inhibitors, okwenza ukuthi i-potassium ingabikho emgqeni.
Kodwa-ke, iningi le-hyperkalemia yilokho okuvame ukuveza phakathi kweziguli ezibhedlela eziphathwe nge-RAAS inhibitors ngokuhluleka kwenhliziyo, isifo sikashukela, nesifo sezinso ezingapheli. Isifo sikashukela kanye nesifo esingenasifo sezinso kubangelwa ukuphefumula kwamathambo kanye ne-glomerulosclerosis, ngokulandelana; lezi zinqubo zokuzivikela zisebenza ndawonye ukuvimbela ikhono lomzimba (izinso) ukuzinqamula i-potassium.
Nakuba i-RAAS inhibitors i-potassium-sparing futhi ingabangela amazinga aphezulu we-potassium noma i-hyperkalemia, ukwehluleka kwenhliziyo, isifo esingasiguli nesifo sikashukela kuphathwa nge-RAAS inhibitors. Ngakho-ke, kungaba usizo ukuthola indlela ephumelela kakhulu yokwelapha i-hyperkalemia kubantu abanezimo abathatha ama-RAAS inhibitors.
Njengamanje, i- hyperkalemia iye yaphathwa kuphela ngezilinganiso zesikhashana ezifana ne-beta agonists, i-calcium, noma i-insulini ne-glucose, konke okuhambisa i-potassium zibe ngamaseli; i-loop noma i-thiazide diuretics, kokubili okungukuthi i-potassium ishaya futhi ikhulise i-excretion ye-potassium; umuthi obizwa ngokuthi i-sodium polystyrene sulfonate (i-Kayexalate), engabangela i-hypomagnesemia, hypokalemia, ukucindezeleka okukhulu kwamathumbu ngisho nesifo sofuba se-necrosis; kanye ne-dialysis. Phakathi nezivivinyo zokwelapha zesigaba sesi-3, i-Patiromer iyanciphisa kakhulu amazinga e-potassium kwiziguli ezinezifo zesifo sikashukela ezazithatha i-RAAS inhibitors futhi zathuthuka kancane zibe ne-hyperkalemia enzima.
I-patiromer yenziwe nge-polymeri edlula emaphethelweni omzimba angasebenzi. Ngenkathi idlula emathangeni omzimba, ithela i-potassium. Ezilingo zomtholampilo, i-Patiromer iboniswe ukuthi iphephile futhi isebenza amaviki angu-52 wonke kubantu abane-hyperkalemia nesifo sikashukela, okusikisela ukuthi kuyindlela yokwelapha ethembisayo. Ngamanye amazwi, abantu abathatha i-RAAS inhibitors bangakugwema i-hyperkalemia ngokuthatha i-Patiromer. Ngaphezu kwalokho, ngemuva kokubamba iqhaza ukuyeka ukuthatha i-Patiromer, ngokushesha baqala i-hyperkalemia futhi. Encwadini ehlobene, kwezinye izifundo, i-Patiromer nayo iboniswe ukuvimbela i-hyperkalemia kubantu abanesifo senhliziyo ababethatha ama-RAAS inhibitors.
Iziguli ezithatha i-Patiromer zabika ezinye imiphumela ezimbi ezibandakanya ukuwohloka kwesifo sezinso ezingapheli, i-hypomagnesemia, ukuwohloka komfutho wegazi ophakeme nokucindezeleka kwamathumbu. Kodwa-ke, kunamaphesenti angu-10 kuphela abahlanganyeli kulolu cwaningo abayekile ukuthatha i-Patiromer ngenxa yale miphumela emibi.
Naphezu kwesithembiso esiboniswe yi-Patiromer phakathi novivinyo lwesigaba sesi-3 somtholampilo , abanye ochwepheshe baye bakhuluma ngokukhathazeka ngalesi sidakamizwa. Okokuqala, laba ochwepheshe babonisa ukuthi kungaba umqondo omuhle ukuqhubeka nokuhlolwa kwe-Patiromer isikhathi esingaphezu konyaka - emva kwakho konke, abanye abantu kuzodingeka bachithe isikhathi esisele sempilo yabo ku-Patiromer ngenkathi bethola i-RAAS inhibitors.
Okwesibili, akucaci ukuthi abantu abathatha i-RAAS inhibitors ne-Patiromer ye-hyperkalemia bayazuza yini ekwelashweni nge-RAAS inhibitors njengalabo abanezigaba ezivamile ze-potassium (i-normokalemia) ethatha i-RAAS inhibitors.
Uma unemibuzo mayelana ne-Patiromer noma yimiphi imithi, sicela wenze i-aphoyintimenti ukuze uxoxisane nalezi zikhathazo nodokotela wakho. Sicela ukhumbule ukuthi udokotela wakho ungumnakekeli onesihawu okufanele ahlose ukukusiza ukuba uhlale unolwazi futhi unolwazi. Ukufunda mayelana nezidakamizwa kanye nokwelapha kwi-Intanethi kuyindlela enhle kakhulu yokuzigcina unolwazi. Noma kunjalo, lolu lwazi kufanele lusekele ukunakekelwa kanye nezeluleko ezinikezwa udokotela wakho.
> Imithombo:
> "Umphumela we-Patiromer kwiSerum Potassium Level in Patients With Hyperkalemia and Diabetic Disease Disease I-AMETHYST-DN Trial Clinical Trial" yi-GL Bakris nabalobi ababambisene nabo abashicilelwe ku-JAMA ngo-2015.
> "Ukwelashwa kwe-Hyperkalemia Kusuka ku-" Hyper K + "Ukushaya Kwekhaya Ukuqalisa?" yi-WC Winklemayer eyanyatheliswa ku-JAMA ngo-2015.