【摘要】 <正> 随着血液透析疗法的开展,许多过去被认为是不治之症的慢性尿毒症病人已能较长期存活,急性肾功能衰竭病人的死亡率亦大幅度下降。其主要原因是:血液透析治疗能有效地清除体内所聚集的大量代谢产物,并能较好地维持机体内环境平衡。然而,由于各种原因,亦可因此引起水与电解质平衡失调,造成严重后果。关于低钾透析液所致的低钾血症,已引起广泛重视。然而非低钾透析液透析后出现低钾血症目前尚未引起充分注意。此种低钾血症的特点为:常发生在严重尿毒症病人经充分透析尿毒症明显改善时,并且于透析结束后血钾仍继更多还原

【Abstract】 Nine cases of severe hypokalemia following hemodialysis with a dialysate of normal plasma potassium concentration were observed among our dialysed patients. This condition frequently occurred in those patients with severe uremia following an effective dialysis, and might reduce to such a dangerous level as to cause cardiac complication especially in those digitalized patients. The mechanism of hypokalemia is apparently an intracellular shift of this cation instead of removal by dialysis. The following factors are considered of significance: 1. activation of insulin following the removal of insulin-inhibitory factors after dialysis, 2. correction of acidosis and change of blood pH from various causes, 3. increase of anion gap (AG) by substances such as carbenicillin or citrate, 4. change of osmolarity of the plasma during and after dialysis. The authors emphasized that the awareness of this complication is of paramount importance in the treatment of such kind of patients.更多还原