I-Hyperkalemia yigama lonyango kwizinga le-potassium yegazi ephakamileyo. I-potassium yinto yeekhemikhali ebalulekileyo ebomini. Kubaluleke ngokukodwa ukusebenza ngokuqhelekileyo kweenkqubo zesebe ezithembela ekuhanjisweni kwempawu zombane-intliziyo, imisipha, kunye neentsholongwane. Kukho izinto ezininzi kunye nezifo ezingabangela i-hyperkalemia kuquka nesifo sesifo, isifo senhliziyo, isifo sikashukela, kunye nemithi ethile.
Kubantu abadala, inqanaba legazi le-potassium eliphakathi kwe-3.6 ne-5.2 mEq / L. Amanqanaba ePotassium aphantsi kakhulu (hypokalemia) okanye aphakamileyo kakhulu angaba iingxaki ezisongela ubomi.
Izizathu eziqhelekileyo
Kukho ezininzi ezinokubangela i-hyperkalemia, kodwa zinokudilizwa zibe ziintlobo ezinkulu ezintathu.
Ukunciphisa Ukunciphisa I-Potassium
Ngenxa yokuba ukugcinwa kwamanqanaba e-potassium asemqoka kubomi, izintso zethu zineendlela ezifanelekileyo zokuxhoma kwi-potassium ukukhusela amanqanaba ethu ukuba aphantsi kakhulu, kunye nokukhupha i-potassium engaphezulu kumchamo ukukhusela amanqanaba ethu ukuba aphezulu kakhulu. Nangona kunjalo, kunye nokusilela kweentso ezinzima okanye izifo zesifo esingasasigxina , ukukwazi kweentso ukukhupha i-potassium kunokusenokungakwazi ukuphazamiseka, kwaye i-hyperkalemia ingayifumana. Ngaphambi kweentsuku zokudida , i-hyperkalemia yinto ebangela ukufa kubantu abaneentsholongwane zesifo.
Ukunciphisa kwi-kidney's excretion ye potassium kunokwenzeka kwakhona nge:
- Isifo sika-Addison (ukungaphumeleli kweengcingo ze-adrenal)
- Ukukhubazeka kwentliziyo
- I-cirrhosis yesibindi
- Amachiza athile achaphazela i- renin-aldosterone system kuquka i- angiotensin-guqula i-enzyme (ACE) inhibitors , i- angiotensin II i-receptor blockers , i-non-steroidal anti-inflammatory drugs (NSAIDs), i-calcinurin inhibitors, i-heparin kunye ne-potassium-sparing diuretics njenge-Aldactone ne-Carospir (i- spironolactone ) kunye no-Inspra (eplerenone)
Ukukhululwa kwePotassium ukusuka kwiiseli
Ngenxa yokuba ingxube ye-potassium ngaphakathi kweeseli zomzimba wakho malunga namaxesha angaphezu kwama-30 ngaphezu kwegazi lakho, nantoni na eyenza ukukhululwa kwe potassium ngaphakathi kweeseli ukuya ngaphandle kweeseli kunokuvelisa i-hyperkalemia. Xa umzimba wakho uqukethe i-asidi eninzi, ebizwa ngokuthi i-acidosis, efana ne- ketoacidosis yesifo sikashukela , i-potassium ikhutshwa ngaphandle kweeseli kwaye ingavelisa i-hyperkalemia ebalulekileyo kwaye inokuba yingozi.
Umonakalo we-tissue unokuvelisa ukutshintshwa kwe-potassium ukusuka ngaphakathi kweeseli ukuya ngaphandle kweeseli, nje kuphela ngenxa yokuphazamiseka kwezibilini zeseli. I-Hyperkalemia evela kumonakalo wesisu ingafumaneka naluphi na uhlobo lwexinzelelo olubi, ukutshiswa, ukuhlinzwa, ukutshabalalisa ngokukhawuleza kweeseli zesisu, i- hemolytic anemia , okanye i- rhabdomyolysis , ukutshatyalaliswa kweeseli ezinamahlunu ezinokuthi zenzeke ngesifo somlilo , .
Ezinye izizathu ezibangela ukukhululwa kwe-potassium kwimizimba yomzimba yakho ziquka:
- Ukuntuleka kwe-insulin okubangela ukuba i-hyperglycemia (kakhulu i-glucose egazini lakho), ezinokuthi zenzeke kwi-diabetes engalawulwayo okanye engalawulwayo
- Ukuntuleka kwe-insulin ngenxa yokuzila ukudla, ingakumbi kubantu abakwi-dialysis
- Ukungabikho kwe-insulin ekuthathile i-somatostatin okanye i-Sandostatin (i-octreotide), i-hormone ezivimbela ama-hormone okukhula
- I-tumor lysis syndrome, eyenzekayo ukuba unayo i-lymphoma okanye i-leukemia kwaye unikezwa i-chemotherapy okanye unyango lwe-radiation
- Beta blockers
- Ukunyelwa igazi
Ukungena ngokweqile kwePotassium
Ukuba usebenza ngokuqhelekileyo iintso, kunzima ukuhlakulela i-hyperkalemia nje ekungenizeni i-potassium kakhulu ekudleni kwakho. Nangona kunjalo, kunokwenzeka ukuba uqhube umgangatho we-potassium ngezinga eliphezulu kakhulu xa uthatha iindleko ezinkulu ze-potassium, ngakumbi xa unesifo esithile seesifo, okanye ukuba usebenzisa iziyobisi ezivimbela i-potassium excretion njengezikhankanywe ngasentla.
Genetics
Kukho iingxaki ezimbini ezingabonakaliyo zokuzalwa ezibangelwa i-hyperkalemia. Ezi zinto ziyakwazi ukufumana uvavanyo lofuzo.
Pseudohypoaldosteronism Uhlobo 1
I-Pseudohypoaldosteronism hlobo 1 (PHA1) yenza kube nzima umzimba wakho ukulawula i-sodium, ebonakalayo kwizintso zakho. Kukho iintlobo ezimbini ze-PHA1: i-autosomal ephezulu ye-PHA1, epholileyo kwaye idla ngokuphucula ngexesha lobuntwaneni, kunye ne-autosomal PAC1 ephindaphindiweyo, enzima kakhulu kwaye ayikuphucula. Le ngxaki ingakhokelela kwi-hyperkalemia kuba ixabiso eliphezulu le-sodium liya kukhutshwa kumchamo wakho, kubangela amanqanaba aphantsi aphezulu kunye namazinga aphezulu e-potassium egazini lakho. Enyanisweni, i-hyperkalemia ithathwa njengenye yezona zinto ziphambili ze-disorder.
Uhlobo lwe-Pseudohypoaldosteronism luhlobo oluthile lubangelwa ukuguqulwa kwamanye amajethi amane achaphazela ukulawulwa kwe-sodium. Ezi zityalo ziquka i-NR3C2 (i-gene eyenza i-autosomal ephezulu i-PHA1), i-SCNN1A, i-SCNN1B, okanye i-SCNN1G, nto leyo eyenza i-autosomal PACI e-PHA1. Le meko ichaphazela kuphela i-1 kuma-80,000 iintsana ezisandul 'ukuzalwa.
Pseudohypoaldosteronism Uhlobo 2
I-Pseudohypoaldosteronism hlobo 2 (PHA2), eyaziwa ngokuba yi-Gordon's syndrome, yinto enye yokufa eyabangela hyperkalemia. Le ngxaki yenza kube nzima ukuba umzimba wakho ulawule i-sodium ne-potassium, okubangele uxinzelelo lwegazi oluphezulu kunye ne-hyperkalemia, kodwa isebenzi yengqondo eqhelekileyo. I-Hyperkalemia ijwayele ukuvela kuqala, ngelixa ixinzelelo legazi eliphezulu likhula emva koko.
I-PHA2 ibangelwa utshintsho kwi-WNK1, WNK4, CUL3, okanye i-KLHL3 yegeni, zonke ezo zinceda ukulawula uxinzelelo lwegazi. Le nto iyinto engaqhelekanga, kodwa ayiyazi ukuba i-PHA2 idla kangakanani.
I-Cardiovascular
Ukungaphumeleli kwintliziyo yesibheno kubonwa njengenye yezimbangela ze-hyperkalemia, njengamanye amachiza abantu abanokuphelelwa yintliziyo rhoqo, kuquka i-diuretics, i-ACE inhibitors kunye ne-beta blockers. Ngenxa yoko, ukuba unesifo senhliziyo esiswini kwaye uthatha nayiphi na le mishanguzo yokugcina ubomi, unokufuna ukunciphisa inani le potassium onayo ekudleni kwakho ukukunciphisa umngcipheko wokuphuhlisa i-hyperkalemia. Ugqirha wakho uya kubeka esweni ngokukhawuleza amanqanaba e-potassium egazini lakho kwaye uqinisekise ukuba unesilinganiselo esincinci seentlobo zamachiza ezibangela amazinga e-potassium.
Izinto zokuPhila kweengozi
Ukuba unesifo sikashukela, phakathi kwezona zizathu ezininzi zokuba kubalulekile ukufumana isifo sakho phantsi kolawulo kuyingozi yokuhlakulela i-hyperkalemia, engakhokelela ekufeni ukuba ibe nzima. Xa isifo sikashukela silawulwa kakubi okanye singalawuleki, uphelisa nge-glucose eninzi kwigazi lakho, udala ukungakwazi kwe-insulin engakhokelela kwi-hyperkalemia nezinye iingxaki ezisongela ubomi. Qiniseka ukuba usebenze nogqirha wakho ukufumana inkqubo yonyango esebenza kuwe ekulawuleni i-glucose yegazi ukuze unciphise iingozi zakho ezinzulu, ezinokusongela ubomi, iziphumo.
> Imithombo:
> I-Reference Reference Home. Pseudohypoaldosteronism Uhlobo 1. AmaZiko eZiko lezeMpilo. ILayibrari yeSizwe ka-US yamayeza. Ipapashwe ngo-Apreli 25, 2018.
> I-Reference Reference Home. Pseudohypoaldosteronism Uhlobo 2. AmaZiko eZiko lezeMpilo. ILayibrari yeSizwe ka-US yamayeza. Ipapashwe ngo-Apreli 25, 2018.
> Abasebenzi beKliniki yabasebenzi. High Potassium (Hyperkalemia). Clinical Mayo. Ihlaziywe ngoJanuwari 11, 2018.
> INtaba iDB. Izizathu kunye nokuVavanywa kwe-Hyperkalemia kuBantu abadala. Isemgangathweno. Ukuhlaziywa ngoJuni 5, 2017.
> I-Sterns RH, uRojas M, uBernstein P, i-Chennupati S. I-Resin exchange exchange Ion-exchange Resins ye-Treatment ye-Hyperkalemia: Ngaba ikhuselekile kwaye iphumelele? Umbhalo we-American Society of Nephrology . Meyi 2010; 21 (5): 733-5. i-doi: 10.1681 / ASN.2010010079.