腹膜透析患者低钾血症影响因素分析

Influencing factors of hypokalemia in peritoneal dialysis patients

目的探讨持续非卧床腹膜透析(CAPD)患者低钾血症的发生情况及相关影响因素。方法对行持续非卧床腹膜透析治疗的86例尿毒症患者的临床资料进行回顾性分析。结果 86例CAPD患者中发生低钾血症25例(29.1%)。高血压肾病10例患者中发生低钾血症2例(20.0%),糖尿病肾病31例患者中发生低钾血症12例(38.7%),慢性肾小球肾炎38例患者中发生低钾血症10例(26.3%),痛风性肾病4例患者中发生低钾血症1例(25.0%)。低钾与非低钾血症患者比较,年龄、血清肌酐(Scr)、血尿素氮(BUN)、血红蛋白(Hb)、血磷、血清白蛋白(ALB)、超敏C反应蛋白(Hs-CRP)水平差异均有统计学意义(P<0.05);透析龄、尿量及腹透超滤量比较差异无统计学意义(P>0.05)。多因素非条件logistic回归分析结果显示,低钾血症的发生与患者血磷、血清肌酐(Scr)、血尿素氮(BUN)、血红蛋白(Hb)、血清白蛋白(ALB)、超敏C反应蛋白(hs-CRP)水平呈正相关,与患者年龄呈负相关。结论腹膜透析患者低钾血症发生率较高,尤其是糖尿病肾病CAPD患者;患者血钾水平与其年龄、营养状态密切相关,及时发现及纠正低钾血症可以提高CAPD患者的生活质量,改善预后。

Objective To explore the occurrence and its related influencing factors of hypokalemia in patients with continuous ambulatory peritoneal dialysis （CAPD）. Methods A clinical data of 86 patients with uremia who carried out continuous ambulatory peritoneal dialysis treatment were retrospectively analyzed. Results Of all the 86 cases, there were 25 cases with hypokalemia （29.1%）, including 2 out of 10 cases with hypertensive nephropathy （20.0%）, 12 out of 31 cases with diabetic nephropathy （ 38.7% ）, 10 out of 38 cases with chronic glomerular nephropathy （ 26.3% ）, and 1 out of 4 cases with gouty nephropathy （25.0%）. There was no significant difference in age, serum creatinine （Scr）, blood urea nitrogen （BUN）, hemoglobin （Hb）, blood phosphorus, serum albumin （ALB）, and hypersensitive c-reactive protein （hs-CRP） between hypokalemia group and non-hypokalemia group. Multivariate non-conditional logistic regression analysis showed that the incidence of hypokalemia was positively correlated with blood potassium, phosphorus, serum creatinine （ Scr）, blood urea nitrogen （ BUN ）, hemoglobin （Hb）, serum albumin, hypersensitive c-reactive protein （hs-CRP）, and was negatively correlated with age. Conclusions Peritoneal dialysis patients has a higher incidence of hypokalemia, specially for CAPD patients with diabetic nephropathy. Serum potassium is closely related to age and nutritional status. Finding and correcting hypokalemia timely can improve the quality of life and the prognosis of CAPD patients.