Hyperkalemia ndi mawu azachipatala omwe ali ndi mphamvu za potaziyamu zapamwamba kwambiri. Potaziyamu ndi chinthu chofunika kwambiri pamoyo. Ndikofunika kwambiri kuti zizolowezi zogwirira ntchito zogwiritsira ntchito mawonekedwe a magetsi-mtima, minofu, ndi misempha. Pali zifukwa zambiri ndi matenda omwe angayambitse hyperkalemia monga matenda a impso, mtima wodwala, shuga, ndi mankhwala ena.
Kwa akuluakulu, msinkhu wa magazi wa potaziyamu uli pakati pa 3.6 ndi 5.2 mEq / L. Ma potaziyamu omwe ali otsika kwambiri (hypokalemia) kapena apamwamba kwambiri akhoza kukhala mavuto owopsa.
Zomwe Zimayambitsa
Pali zifukwa zambiri zomwe zimayambitsa matenda a hyperkalemia, koma zingathetsedwe m'magulu atatu akuluakulu.
Kuchepetsa Kuwonjezera kwa Potassium
Chifukwa kusungidwa kwa ma potaziyamu ndizofunikira kwambiri pamoyo wathu, impso zathu zimakhala ndi njira zogwiritsira ntchito potaziyamu kuti zisafike pochepa kwambiri, komanso kuti tipewe potaziyamu owonjezera mu mkodzo kuti tipewe kutsika kwambiri. Komabe, ali ndi vuto la impso lopweteka kapena matenda a impso , kuthekera kwa impso kusokoneza potaziyamu nthawi zambiri kumakhala kovuta, ndipo hyperkalemia ikhoza kugwiritsidwa ntchito. Asanafike masiku a dialysis , hyperkalemia inali nthawi zambiri imene imapha anthu omwe ali ndi matenda a impso.
Kuchepa kwa impso za potaziyamu kungachepetsenso ndi:
- Matenda a Addison (kulephera kwa adrenal glands)
- Kusokonezeka mtima kwa mtima
- Cirrhosis ya chiwindi
- Mankhwala ena omwe amachititsa kachilombo ka aldosterone kuphatikizapo mavitamini otchedwa angiotensin (ACE) inhibitors , mankhwala a angiotensin II, othandizana ndi anti-inflammatory drugs (NSAIDs), calcineurin inhibitors, heparin, ndi potassium-sparing diuretics monga Aldactone ndi Carospir ( spironolactone) ) ndi Inspra (eplerenone)
Kusulidwa kwa Potassium Ku Maselo
Chifukwa potaziyamu mkati mwa maselo a thupi lanu nthawi pafupifupi 30 kuposa momwe ilili m'magazi anu, chirichonse chimene chimapangitsa kuti potassium yowonjezeredwa kuchokera mkati mwa maselo kupita kunja kwa maselo akhoza kupanga hyperkalemia. Pamene thupi lanu liri ndi asidi ochuluka, otchedwa acidosis, monga matenda a shuga ketoacidosis , potaziyamu imatuluka mumaselo anu ndipo ikhoza kutulutsa hyperkalemia yowopsa komanso yotha kupha moyo.
Kuwonongeka kwa minofu kungapangitsenso kusintha kwa potaziyamu kuchokera mkati mwa maselo mpaka kunja kwa maselo, kungokhala ndi maselo osokoneza bongo. Matenda a hyperkalemia amatha kuchitika ndi mtundu uliwonse wa zoopsa, kutentha, kuchitidwa opaleshoni, kuwonongeka kwa maselo amtundu, hemolytic anemia , kapena rhabdomyolysis , kuwonongeka kwa maselo a mitsempha omwe angathe kuchitika ndi kupweteka kwa kutentha , kapena kupweteka kwa mankhwala osokoneza bongo kapena mankhwala osokoneza bongo .
Zina zomwe zingayambitse potassium kutuluka m'thupi lanu ndi izi:
- Kulephera kwa insulini komwe kumayambitsa matenda a hyperglycemia (kutaya shuga kwambiri m'magazi anu), monga momwe angathere ndi matenda a shuga osatetezedwa
- Kutaya kwa insulini chifukwa cha kusala, makamaka kwa anthu omwe ali pa dialysis
- Kulephera kwa insulin kuchotsa somatostatin kapena Sandostatin (octreotide), mahomoni omwe amaletsa mahomoni owonjezeka
- Tumor lysis syndrome, yomwe ikhoza kuchitika ngati muli ndi lymphoma kapena khansa ya m'magazi ndipo mukupatsidwa mankhwala a chemotherapy kapena mankhwala a radiation
- Ophwanya Beta
- Kuika magazi
Kuchuluka Kwambiri kwa Potaziyamu
Ngati mumagwira ntchito impso, ndizovuta kuti mukhale ndi hyperkalemia musangowonjezera potaziyamu wambiri mu zakudya zanu. Komabe, n'zotheka kuyendetsa kwambiri potaziyamu kwambiri ngati mutenga zowonjezera zowonjezera, makamaka ngati muli ndi matenda ena a impso, kapena ngati mukugwiritsa ntchito mankhwala osokoneza bongo omwe amaletsa potassium excretion monga omwe tatchulidwa pamwambapa.
Genetics
Pali zovuta ziwiri zosabadwa zomwe zimayambitsa hyperkalemia. Izi zikhoza kupezedwa ndi mayeso a ma gene.
Pseudohypoaldosteronism Thayitsani 1
Mtundu wa pseudohypoaldosteronism 1 (PHA1) umapangitsa thupi lanu kukhala lovuta kulamulira sodium, yomwe imapezeka makamaka impso zanu. Pali mitundu iwiri ya PHA1: Pos1 yodziwika bwino kwambiri, yomwe ndi yofatsa ndipo nthawi zambiri imagwira bwino panthawi ya ubwana, komanso kupyolera muyezo wa PHA1, womwe ndi wovuta kwambiri ndipo suli bwino. Matendawa angapangitse hyperkalemia chifukwa chakuti sodium yapamwamba imatulutsidwa m'kodzo, ndipo imayambitsa ma sodium ndi potassium m'magazi anu otsika. Ndipotu, hyperkalemia imaonedwa kuti ndiyo imodzi mwazofunikira za matendawa.
Mtundu wa pseudohypoaldosteronism 1 umayambitsidwa ndi kusintha kwa jini imodzi mwa ma jini anayi omwe amakhudza lamulo la sodium. Ma jini amenewa ndi NR3C2 (jini limene limayambitsa PHA1 kwambiri), SCNN1A, SCNN1B, kapena SCNN1G, zomwe zimayambitsa PHA1 yambiri. Matendawa amakhudza pafupifupi 1 pa 80,000 makanda obadwa kumene.
Pseudohypoaldosteronism Pangani 2
Mtundu wa pseudohypoaldosteronism 2 (PHA2), womwe umatchedwanso Gordon's syndrome, ndi mtundu winanso umene umayambitsa hyperkalemia. Matendawa amachititsa kuti thupi lanu likhale losavuta kuti likhale ndi sodium ndi potassium, zomwe zimayambitsa kuthamanga kwa magazi ndi hyperkalemia, komabe ntchito ya impso yachibadwa. Hyperkalemia amayamba kuchitika, pamene kuthamanga kwambiri kwa magazi kumawuluka mtsogolo.
PHA2 imayambitsidwa ndi kusintha kwa WNK1, WNK4, CUL3, kapena gene ya KLHL3, zonse zomwe zimathandiza kuti magazi azikhala ndi nkhawa. Izi ndizonso matenda osadziwika, koma sadziwa kuti nthawi zambiri PHA2 imapezeka.
Mitsempha
Kutaya mtima kwa mtima kumatengedwa kuti ndi chimodzi mwa zifukwa zomwe zimayambitsa hyperkalemia, monga zina mwa mankhwala amene anthu omwe amatha kupweteka mtima, kuphatikizapo diuretics, ACE inhibitors, ndi beta blockers. Chifukwa chaichi, ngati muli ndi vuto la mtima wamtima komanso mutenga mankhwala ena opulumutsa moyo, mungafunikire kuchepetsa potaziyamu yomwe muli nayo mu zakudya zanu kuti muchepetse chiopsezo cha hyperkalemia. Dokotala wanu angayang'anitsenso mosamala ma potaziyamu m'magazi anu ndipo onetsetsani kuti muli ndi kuchuluka kwa mitundu ya mankhwala omwe amachititsa kuti mazamu a potassium ayambe kuwonjezeka.
Zochitika Zowopsa Kwamoyo
Ngati muli ndi matenda a shuga, pakati pa zifukwa zambiri zomwe zimakhala zofunikira kuti matenda anu aziyendetsedwa ndi chiopsezo chokhala ndi hyperkalemia, zomwe zingapangitse imfa kuti ikhale yovuta. Pamene matenda anu a shuga sakulamuliridwa kapena osasamalidwa, mumatha kukhala ndi shuga kwambiri m'magazi anu, kupanga vuto la insulini lomwe lingayambitse hyperkalemia ndi mavuto ena owopsa. Onetsetsani kuti muzigwira ntchito ndi dokotala kuti mupeze pulogalamu ya mankhwala yomwe ikukuthandizani kuti muchepetse magazi anu kotero kuti muthe kuchepetsa kuopsa kwanu, zomwe zingawopsyeze moyo wanu, zotsatira zake.
> Zotsatira:
> Zolemba Zanyumba Zachibadwa. Pseudohypoaldosteronism Thayitsani 1. National Institutes of Health. Laibulale ya National National Medicine. Lofalitsidwa pa April 25, 2018.
> Zolemba Zanyumba Zachibadwa. Pseudohypoaldosteronism Pangani 2. National Institutes of Health. Laibulale ya National National Medicine. Lofalitsidwa pa April 25, 2018.
> Chipatala cha Mayo Clinic. Potaziyamu (Hyperkalemia). Chipatala cha Mayo. Idasinthidwa pa January 11, 2018.
> Phiri la DB. Zimayambitsa ndi Kufufuza kwa Hyperkalemia mwa Achikulire. Zaposachedwa. Idasinthidwa pa June 5, 2017.
> Zam'mbuyo RH, Rojas M, Bernstein P, Chennupati S. Ion-exchange Resins kwa Chithandizo cha Hyperkalemia: Kodi Ndi Otetezeka Ndiponso Ogwira Ntchito? Journal ya American Society of Nephrology . May 2010; 21 (5): 733-5. lembani: 10.1681 / ASN.2010010079.