Symptom of hyperkalemia is a sign of a disease in which the amount of potassium in the blood serum rises to more than 5 mmol / L. In the human body, potassium is mainly concentrated in cells, ensuring the synthesis of DNA and protein, cell growth, normal function of enzymes, etc. Only 2% of potassium is in the extracellular fluid. Renal and adrenal mechanisms support the homeostasis of potassium, the first responsible for the withdrawal of potassium from the body, and the second provides a transition of potassium into cells from extracellular fluid. The action of potassium is to provide the electrical potential of cell membranes. Symptom of hyperkalemia in the moderate stage is a decrease in the resting potential of membranes of nerve and muscle cells, which affects the increase in the excitability of cells. If the concentration of potassium in the blood rises to 7.5 mmol / l, the cells lose their excitability completely.
Hyperkalemia: symptoms of the disease
Hyperkalemia is accompanied by depolarization of cells and a decrease in their excitability, which causes muscle weakness, paresis and respiratory failure. The cardiotonic action of potassium is manifested by high pointed tars T on an electrocardiogram. In some cases, the disease affects the prolongation of the PQ-interval and the expansion of the QRS complex, as well as the slowing of AV-conduction and the loss of the P wave. All these manifestations lead to ventricular fibrillation and asystole.
Symptom of hyperkalemia: the causes of
In healthy individuals, potassium intake in high doses very rarely causes the disease. The main cause of the disease with normal kidney function is adrenal insufficiency. In contrast, the oliguric OPN raises the level of potassium in the blood in a short time without an increased potassium load. In a number of patients with chronic renal failure, the degree of hyperkalemia is affected by aldosterone deficiency, which is responsible for potassium secretion. This condition is usually observed with diabetic nephropathy, tubulointerstitial diseases of the kidneys and damage to the juxtaglomerular apparatus.
Diagnosis
Hyperkalemia is detected in the laboratory study of blood serum at the potassium level and electrocardiographic study.
Treatment of hyperkalemia
The first signs of hyperkalemia should not be ignored. An acute onset that threatens the patient's life is treated with an intravenous injection of calcium gluconate solution every 2-3 hours. An increase in the calcium content in the blood reduces the threshold potential and increases the difference between the action and rest potential , reducing the excitability of cells. Intravenous administration of sodium hydrogencarbonate facilitates the transition of potassium from extracellular fluid directly into cells. And to prevent hypokalemia, insulin is injected intravenously, which increases the activity of the sodium-potassium pump and, thus, the intake of potassium into the cells. To reduce the potassium concentration in the serum, ion exchange sodium phosphate cellulose resin is prescribed, often combining it with sorbitol. The purpose of the resin is advisable for the prevention of disease in ARF. Symptom of hyperkalemia in the developed stage is removed by hemodialysis or peritoneal dialysis with a non-potassium solution.