维持性血液透析患者高钾血症的相关因素分析 及环硅酸锆钠散辅助干预效果研究.

Objective: To analyze the related factors of hyperkalemia in maintenance hemodialysis(MHD) patients, and observe the curative Effect of adjuvant intervention with sodium zirconate cyclosilicate powder. Methods: 134 MHD patients who were admitted to our hospital from March 2020 to March 2022 were included. Patient data were collected through our hospital’s medical record system, and the occurrence of hyperkalemia was used as the grouping criteria: they were divided into normal blood potassium group(n=49) and hyperkalemia group(n=85). Multivariate Logistic regression analysis was used to analyze the related factors of hyperkalemia in MHD patients. Patients in hyperkalemia group were divided into control group(receiving MHD treatment) and observation group(receiving sodium zirconate cyclosilicate powder on the basis of MHD intervention) by random number table method. The relevant indexes and adverse reactions before and after hyperkalemia intervention were compared in the two groups. Results: Among 134 MHD patients, 49(36.57%)with normal blood potassium were included in the normal blood potassium group, and 85(63.43%) with hyperkalemia were included in the hyperkalemia group. The results of univariate analysis showed that hyperkalemia in MHD patients was related to parathyroid hormone(PTH), combined with diabetes, previous history of hyperkalemia, the number of blood potassium tests before dialysis, ultrafiltration volume, blood flow volume, hemoglobin(Hb), high-sensitivity C-reactive protein(hs-CRP), urea, uric acid, blood creatinine, blood sodium, albumin, and blood phosphorus(P＜0.05). The results of multivariate Logistic regression analysis showed that higher urea, higher blood sodium, higher blood phosphorus, higher albumin, higher Hb, combined with diabetes, and less blood potassium tests before dialysis were the risk factors for hyperkalemia in MHD patients(P＜0.05). The blood potassium in the control group and the observation group after intervention decreased, and the observation group was lower than the control group(P＜0.05). There was no significant difference in the incidence of adverse reactions between the control group and the observation group (P＞0.05). Conclusion: The main related factors to hyperkalemia in MHD patients are urea, blood sodium, blood phosphorus, albumin, Hb, combined with diabetes, and the number of blood potassium tests before dialysis. The application of sodium zirconate cyclosilicate powder adjunctive intervention in the treatment of hyperkalemia can effectively improve the blood potassium level, which is safe and effective. [ABSTRACT FROM AUTHOR]