慢性肾脏病患者发生高钾血症的相关因素

目的探讨慢性肾脏病(chronic kidney disease,CKD)发生高钾血症的危险因素。方法回顾性分析398例CKD病人,使用单因素分析和多因素回归方法分析血管紧张素转换酶抑制剂/血管紧张素II受体阻滞剂(ACEI/ARB),螺内酯,长期补钾等因素与高钾血症之间的关系。结果高钾血症组中CKD3到5期的患者,服用ACEI/ARB,螺内酯的比例高于对照组,差异具有统计学意义(P<0.05)。多元Logistic回归分析发现ACEI/ARB,螺内酯,长期补钾是CKD病人发生高钾血症的独立危险因素(P<0.05)。结论 ACEI/ARB,螺内酯,长期补钾,是CKD病人发生高钾血症的重要原因,临床用药需警惕。

Objective To investigate the risk factors for hyperkalemia in chronic kidney disease（CKD）. Methods The data of 398 cases with CKD were analyzed retrospectively. Sigle and multiple factors analysis approach were adopted to probe the relationship between hyperkalemia and other factors including ACEI/ARB, spironolactone and longtime potassium supplements, ect. Results Univariate analysis showed that the ACEI/ARB, spironolactone and potassium supplements were statistically significant risk factor of hyperkalemia （P〈0.05）. Multivariate logistic regression analysis revealed that the independent risk factors of hyperkalemia were ACEI/ARB, spironolactone and potassium supplements （P〈0.05）. Conclusion ACEI/ ARB, spironolactone and potassium supplements are the main clinical factors in relationship to hyperkalemia in CKD.