アブストラクト
| Title | カリウム代謝異常 |
|---|---|
| Subtitle | 特集 最適な治療・管理がわかる 水・電解質・酸塩基平衡異常 代表的な電解質異常へのアプローチ |
| Authors | 脇田篤*1, 木内丈滉*2, 龍華章裕*3 |
| Authors (kana) | |
| Organization | *1名古屋医療センター診療看護師(NP), *2名古屋医療センター薬剤部, *3リウゲ内科小田井クリニック |
| Journal | 月刊薬事 |
| Volume | 66 |
| Number | 5 |
| Page | 865-872 |
| Year/Month | 2024 / 4 |
| Article | 報告 |
| Publisher | じほう |
| Abstract | 「Key Points」●カリウム(K)は細胞内の主要な陽イオンであり, (1)腸管からの吸収・排泄, (2)細胞内外の移動, (3)腎臓での調節 - の3つの調節を受ける. ●高K血症は致死性不整脈を誘発しうる緊急疾患の一つであり, KDIGOの指針に従って不整脈の発症予防, 血清K値の低下を図る. ●低K血症も致死性不整脈を誘発しうる疾患であり, 治療としては主に経口からのK+補充を行う. ●超重症の低K血症に対して経静脈的にK+を投与する場合は, 点滴中のK+濃度, 投与速度に注意が必要である. |
| Practice | 薬学 |
| Keywords |
- 全文ダウンロード: 従量制、基本料金制の方共に803円(税込) です。
参考文献
- 1) Gennari FJ : Hypokalemia. N Engl J Med, 339 : 451-458, 1998
- 2) Agarwal R, et al : Pathophysiology of potassium absorption and secretion by the human intestine. Gastroenterology, 107 : 548-571, 1994
- 3) Wilson DR, et al : The chemical composition of faeces in uraemia, as revealed by in-vivo faecal dialysis. Clin Sci, 35 : 197-209, 1968
- 4) 柴垣有吾 : より理解を深める! 体液電解質異常と輸液 改訂3版. 中外医学社, 2020
- 5) Hunter RW, et al : Hyperkalemia : pathophysiology, risk factors and consequences. Nephrol Dial Transplant, 34(Suppl 3) : iii2-iii11, 2019
残りの17件を表示する
- 6) Clase CM, et al ; Conference Participants : Potassium homeostasis and management of dyskalemia in kidney diseases: conclusions from a Kidney Disease: Improving Global Outcomes(KDIGO) Controversies Conference. Kidney Int, 97 : 42-61, 2020
- 7) Giebisch GH, et al : Potassium transport--an update. J Nephrol, 23 Suppl 16 : S97-S104, 2010
- 8) Giebisch G, et al : Renal and extrarenal regulation of potassium. Kidney Int, 72 : 397-410, 2007
- 9) Palmer BF : A physiologic-based approach to the evaluation of a patient with hypokalemia. Am J Kidney Dis, 56 : 1184-1190, 2010
- 10) Kamel KS, et al : Renal potassium physiology: integration of the renal response to dietary potassium depletion. Kidney Int, 93 : 41-53, 2018
- 11) Durfey N, et al : Severe Hyperkalemia: Can the Electro-cardiogram Risk Stratify for Short-term Adverse Events? West J Emerg Med, 18 : 963-971, 2017
- 12) Ryuge A, et al : Warning: The ECG May Be Normal in Severe Hyperkalemia. Intern Med, 56 : 2243-2244, 2017
- 13) Rose BD, et al : Clinical Physiology of Acid-Base and Electrolyte Disorders, 5th ed. McGraw Hill, 2000
- 14) Schaefer TJ, et al : Disorders of potassium. Emerg Med Clin North Am, 23 : 723-747, 2005
- 15) Moussavi K, et al : Management of Hyperkalemia With Insulin and Glucose: Pearls for the Emergency Clinician. J Emerg Med, 57 : 36-42, 2019
- 16) Harel Z, et al : Optimal Dose and Method of Administration of Intravenous Insulin in the Management of Emergency Hyperkalemia: A Systematic Review. PLoS One, 11 : e0154963, 2016
- 17) Geng S, et al : Sodium bicarbonate administration and subsequent potassium concentration in hyperkalemia treat-ment. Am J Emerg Med, 50 : 132-135, 2021
- 18) Kosiborod M, Ret al : Effect of sodium zirconium cyclosilicate on potassium lowering for 28 days among outpatients with hyperkalemia: the HARMONIZE randomized clinical trial. JAMA, 312 : 2223-2233, 2014
- 19) Kosiborod M, et al : Sodium zirconium cyclosilicate for urgent therapy of severe hyperkalemia. N Engl J Med, 372 : 1577-1578, 2015
- 20) Asmar A, et al : A physiologic-based approach to the treat-ment of a patient with hypokalemia. Am J Kidney Dis, 60 : 492-497, 2012
- 21) Mount DB : Evaluation of the adult patient with hypokalemia. UpToDate, 2023(Last updated Dec 05)
- 22) Cohn JN, et al : New guidelines for potassium replacement in clinical practice: a contemporary review by the National Council on Potassium in Clinical Practice. Arch Intern Med, 160 : 2429-2436, 2000


