环硅酸锆钠治疗维持性血液透析患者高钾血症的疗效

Efficacy of sodium zirconium cyclosilicate in treatment of hyperkalemia in patients undergoing maintenance hemodialysis

目的观察环硅酸锆钠治疗维持性血液透析(MHD)患者高钾血症的疗效。方法MHD患者64例,血液透析前血钾≥5.3 mmol/L,分为两组。对照组28例,给予低钾饮食方案干预;观察组36例,加用环硅酸锆钠,连续治疗6周。比较两组治疗前后的相关指标,记录治疗过程中不良反应发生情况。结果治疗后,观察组血钾水平低于治疗前,且低于对照组(P<0.05);两组治疗前后血钠、血镁、血磷、血钙、BMI、ALT和白蛋白等指标无统计学差异(P>0.05)。治疗期间,观察组1例患者发生双下肢轻度水肿,2例患者出现便秘,对照组1例患者出现便秘,均未发现其他严重的不良反应。结论在低钾饮食基础上,环硅酸锆钠治疗MHD患者高钾血症有较好的疗效及安全性,且不影响其他电解质、肝功能和营养状况。

Objective To observe the efficacy of sodium zirconium cyclosilicate in the treatment of hyperkalemia in the patients undergoing maintenance hemodialysis(MHD).Methods A total of 64 patients undergoing MHD were treated with low potassium diet(group A,28 cases) or low potassium diet plus sodium zirconium cyclosilicate(group B,36 cases) for 6 weeks.Serum potassium before hemodialysis was ≥ 5.3 mmol/L in all patients.The related indicators were detected before and after treatment in both groups.The adverse responses during treatment were recorded.Results Serum potassium level after treatment was lower than that before in group B,which was lower than that in group A(P<0.05).Serum levels of sodium, magnesium, phosphorus and calcium, and BMI,ALT and albumin were not significantly different before and after treatment in both groups(P>0.05).During treatment, a mild edema of the lower limbs was seen in one patient and constipation occurred in 2 patients in group B.Constipation happened in one patient of group A.No serious adverse responses were seen in two groups.Conclusion On the basis of low potassium diet, sodium zirconium cyclosilicate has better effect and safety in treating hyperkalemia in the patients undergoing MHD,which has no adverse effects on the other electrolytes, liver function and nutritional status.