Tom 18, Nr 1 (2021)
Artykuł przeglądowy
Opublikowany online: 2021-05-27
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791
Wyświetlenia/pobrania artykułu
128
Zaburzenia gospodarki potasowej u chorych z nadciśnieniem tętniczym
1
, 1
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Choroby Serca i Naczyń 2021;18(1):1-19.
Streszczenie
Zaburzenia gospodarki potasowej obejmują hiperkaliemię i hipokaliemię. Hiperkaliemia jest powikłaniem stosowania leków zmniejszających wytwarzanie reniny w aparacie przykłębuszkowym, ograniczających aktywność enzymu konwertującego angiotensynę, antagonistów receptora angiotensyny, zmniejszających wytwarzanie aldosteronu, zmniejszających aktywność nabłonkowego kanału sodowego oraz leków zmniejszających ilość sodu docierającego do cewki zbiorczej. Ponadto hiperkaliemia występuje u chorych na przewlekłą chorobą nerek oraz z ostrym uszkodzeniem nerek. Hipokaliemia natomiast stanowi najczęściej powikłanie stosowania tiazydowych i tiazydopodobnych leków moczopędnych, pętlowych leków moczopędnych, hiperaldosteronizmu pierwotnego, a także spożywania produktów zawierających lukrecję. Mechanizmem prowadzącym do hipokaliemii w wyżej wymienionych sytuacjach jest nadmierna utrata potasu z moczem. W celu zmniejszenia ryzyka hiperkaliemii i hipokaliemii należy przede wszystkim monitorować stężenie potasu w osoczu u wszystkich chorych ze zwiększonym ryzykiem wystąpienia tych zaburzeń, a następnie — biorąc pod uwagę aktualną kaliemię — modyfikować leczenie farmakologiczne i dietetyczne.
Słowa kluczowe: hiperkaliemiahipokaliemianadciśnienie tętnicze
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