I-Hyperkalemia yigama lezokwelapha lamazinga we-potassium ephezulu kakhulu. I-Potassium iyisici samakhemikhali esibalulekile ekuphileni. Kubaluleke kakhulu ekusebenzeni okujwayelekile kwezinhlelo zomzimba ezithembele ekudlulisweni kwamasignali kagesi-inhliziyo, imisipha, nezinzwa. Kunezici eziningi nezifo ezingabangela i-hyperkalemia kuhlanganise nesifo sezinso, ukwehluleka kwenhliziyo, isifo sikashukela, nemithi ethile.
Kubantu abadala, izinga elivamile legazi le-potassium liphakathi kuka-3.6 no-5.2 mEq / L. Izinga le-potassium elincane kakhulu (hypokalemia) noma eliphakeme kakhulu lingaba izinkinga ezisongela ukuphila.
Izimbangela ezivamile
Kunezimbangela eziningi ezingase zenzeke nge-hyperkalemia, kodwa zingahle zihlukaniswe zibe izigaba ezintathu ezinkulu.
Ukunciphisa Ukunciphisa Kwe-Potassium
Ngenxa yokuthi ukugcinwa kwamazinga ajwayelekile e-potassium kubaluleke kakhulu empilweni, izinso zethu zinendlela ephumelelayo yokulenga i-potassium ukuze kuvinjelwe amazinga ethu ukuba aphansi kakhulu, futhi futhi asebenzise i-potassium ngokweqile emcimbini ukuvimbela amazinga ethu ukuba aphezulu kakhulu. Kodwa-ke, ngokuhluleka kwezinso ezinzima noma isifo sezinso ezingapheli , ikhono lezinso zokungafaki i-potassium ngokuvamile liyakwazi ukuphazamiseka, futhi i-hyperkalemia ingase iqiniseke. Ngaphambi kwezinsuku ze- dialysis , i-hyperkalemia yayiyisizathu esiningi sokufa kubantu abanezinso zezinso.
Ukuncipha kwe-intretion of potassium yezinso kungase kwenzeke nge:
- Isifo sika-Addison (ukwehluleka kwezigulane eziyingozi)
- Ukuhluleka kwenhliziyo ukulahla
- I-cirrhosis yesibindi
- Imithi ethile ethinta i- renin-aldosterone system ehlanganisa i- angiotensin-yokuguqula i-enzyme (ACE) inhibitors , i- angiotensin II receptor blockers , izidakamizwa ezingavimba ukuvuvukala (ama-NSAID), i-calcinurin inhibitors, i-heparin, ne-potassium-sparing diuretics njenge-Aldactone ne-Carospir (i- spironolactone ) no-Inspra (eplerenone)
Ukukhululwa kwe-Potassium Kwamaseli
Ngenxa yokuthi i-potassium ngaphakathi kwamangqamuzana omzimba wakho cishe izikhathi ezingaphezu kuka-30 ngaphezu kwegazi lakho, noma yini edala ukwanda okukhulu kwe-potassium kusuka ngaphakathi kwamaseli kuya ngaphandle kwamaseli kungakhipha i-hyperkalemia. Uma umzimba wakho uqukethe i-asidi eningi kakhulu, okuthiwa i-acidosis, njenge- ketoacidosis yesifo sikashukela , i-potassium idluliselwa emangqamuzaneni akho futhi ingaveza i-hyperkalemia ebalulekile futhi engase isongela impilo.
Umonakalo wesikhumba ungaphinda ukhiqize ushintsho lwe-potassium kusuka ngaphakathi kwamaseli kuya ngaphandle kwamaseli, nje kuphela ngamabhethini esiphazamiso esiphazamisayo. I-Hyperkalemia evela ekulimaleni komzimba kungenzeka nanoma yiluphi uhlobo lokudabuka okukhulu, ukushisa, ukuhlinzwa, ukubhujiswa okusheshayo kwamangqamuzana e-tumor, i- hemolytic anemia , noma i- rhabdomyolysis , ukubhujiswa kwamangqamuzana omzimba angase avele ngesifo sokushisa , noma nge-stupor ekhishwa izidakamizwa noma ezidakamizwa .
Ezinye izimbangela ezingabangela ukukhululwa kwe-potassium ezivela emzimbeni womzimba wakho zihlanganisa:
- Ukuntuleka kwe-insulin okuholela ekukhuliseni i-hyperglycemia (i-glucose ngokweqile egazini lakho), njengokungenzeka kulesifo sikashukela esilawulwayo noma esingalawulwa
- Ukuntuleka kwe-insulin ngenxa yokuzila ukudla, ikakhulukazi kubantu abakwi-dialysis
- Ukuntuleka kwe-insulini ekuthathweni kwe-somatostatin noma i-Sandostatin (octreotide), ama-hormone avimbela ama-hormone okukhula
- I-tumor lysis syndrome, engenzeka uma une-lymphoma noma i-leukemia futhi unikezwa ngamakhemikhali noma imithi yokwelashwa
- Abavimba be-Beta
- Ukumpontshelwa igazi
Ukutholakala ngokweqile kwe-Potassium
Uma usebenza ngokuvamile izinso, kunzima kakhulu ukuthuthukisa i-hyperkalemia nje ekungenizeni i-potassium kakhulu ekudleni kwakho. Kodwa-ke, kungenzeka ukushayela amazinga e-potassium ephakeme kakhulu uma uthatha izithako eziningi ze-potassium, ikakhulukazi uma unezifo ezithile zezinso, noma uma usebenzisa izidakamizwa ezivimbela i-potassium excretion njengezikhulunywe ngenhla.
I-Genetics
Kunezifo ezimbili ezingavamile zokuzalwa ezibangelwa i-hyperkalemia. Laba bobabili bangatholakala ukuthi banezifo zofuzo.
Pseudohypoaldosteronism Uhlobo 1
Uhlobo lwe-Pseudohypoaldosteronism 1 (PHA1) lwenza kube nzima emzimbeni wakho ukulawula i-sodium, eyenzeka ngokuyinhloko ezinso zakho. Kunezinhlobo ezimbili ze-PHA1: i-autosomal ephezulu ye-PHA1, enobumnene futhi ngokuvamile ithuthukisa ngesikhathi seyingane, ne-autosomal PHA1 ephindaphindiwe, eyingozi kakhulu futhi engcono. Lesi sifo singabangela i-hyperkalemia ngoba inani elikhulu le-sodium likhishwa emcinini wakho, okwenza amazinga aphansi amazinga aphezulu ne-high potassium egazini lakho. Eqinisweni, i-hyperkalemia ibhekwa njengenye yezici eziyinhloko zalesi sifo.
Uhlobo lwe-Pseudohypoaldosteronism lu-1 lubangelwa ukuguqulwa komzimba kwesinye sezakhi zofuzo ezine ezithinta umlayezo we-sodium. Lezi zakhi zofuzo zihlanganisa i-NR3C2 (isakhi esibangela i-autosomal PHA1 ephezulu), i-SCNN1A, i-SCNN1B, noma i-SCNN1G, okubangela i-autosomal PHA1 ngokweqile. Lesi simo sithinta kuphela cishe 1 ku-80,000 izinsana ezisanda kuzalwa.
Pseudohypoaldosteronism Uhlobo 2
Uhlobo lwe-Pseudohypoaldosteronism 2 (PHA2), owaziwa nangokuthi i-Gordon's syndrome, yisinye isimo esibuhlungu esibangela i-hyperkalemia. Le disorder yenza kube nzima emzimbeni wakho ukulawula kokubili i-sodium ne-potassium, okuholela ekucindezeni kwegazi eliphezulu ne-hyperkalemia, kodwa umsebenzi osebenzayo wezinso. I-Hyperkalemia ijwayele ukufika kuqala, kuyilapho ukucindezeleka kwegazi kuqhubeka kamuva.
I-PHA2 ibangelwa ukuguqulwa kwesimo se-WNK1, WNK4, CUL3, noma isakhi se-KLHL3, konke okusiza ukulawula ukucindezeleka kwegazi. Lokhu futhi kuyisifo esingavamile, kodwa asikwazi ukuthi i-PHA2 ivele kaningi kangakanani.
I-cardiovascular
Ukuhluleka kwenhliziyo ukuhlushwa kubhekwa njengenye yezimbangela ze-hyperkalemia, njengenye yemithi abantu abanokuhluleka kwenhliziyo ngokuvamile, okubandakanya ukuguqulwa kwe-diuretics, i-ACE inhibitors, ne-beta blockers. Ngenxa yalokhu, uma unesifo se-heart congestive futhi uthatha noma yikuphi kwalezi zindlela zokulondoloza impilo, ungadinga ukulinganisa inani le-potassium onalo ekudleni kwakho ukusiza ukunciphisa ingozi yokuthuthukisa i-hyperkalemia. Udokotela wakho uzophinde aqaphele ngokucophelela amazinga e-potassium egazini lakho futhi uqinisekise ukuthi usezingeni elincane lemithi yezidakamizwa ezenza amazinga e-potassium akhule.
Izindlela Zengozi Yokuphila
Uma unesifo sikashukela, phakathi kwezizathu eziningi zokuthi kungani kubalulekile ukuthola isifo sakho ngaphansi kokulawula ingozi yokuthuthukisa i-hyperkalemia, engabangela ukufa uma kuba nzima. Uma isifo sikashukela sakho singalawulwa kahle noma singalawulwa, usuqeda i-glucose ngokweqile emzimbeni wakho wegazi, udala ukungabi khona kwe-insulini okungabangela i-hyperkalemia nezinye izinkinga ezisongela ukuphila. Qinisekisa ukuthi usebenza nodokotela wakho ukuthola uhlelo lwezokwelapha olukusebenzela ekulawuleni i-glucose yegazi lakho ukuze unciphise izingozi zakho ezingathí sina, okungenzeka zisengozini, imiphumela.
> Imithombo:
> I-Reference Home yase-Genetics. Pseudohypoaldosteronism Uhlobo 1. Izikhungo zezempilo zikazwelonke. Ilabhulali Kazwelonke Yezokwelapha yase-US. Ishicilelwe ngo-Ephreli 25, 2018.
> I-Reference Home yase-Genetics. Pseudohypoaldosteronism Uhlobo 2. Izikhungo zezempilo zikazwelonke. Ilabhulali Kazwelonke Yezokwelapha yase-US. Ishicilelwe ngo-Ephreli 25, 2018.
> Abasebenzi beMayo Clinic. I-Potassium ephezulu (Hyperkalemia). I-Mayo Clinic. Ibuyekezwe ngoJanuwari 11, 2018.
> Mount DB. Izimbangela nokuhlolwa kwe-Hyperkalemia kubantu abadala. Kusesikhathini. Kubuyekezwe ngo-Juni 5, 2017.
> I-Sterns RH, i-Rojas M, i-Bernstein P, i-Chennupati S. Ion-exchange Resins ye-Treatment Hyperkalemia: Ingabe iphephile futhi iphumelele? Umagazini we-American Society of Nephrology . May 2010; 21 (5): 733-5. i-doi: 10.1681 / ASN.2010010079.