Daawada Cusbada Daroogada ee Cusub waxay muujinaysaa Ballanqaadka Daaweynta Hyperkalemia
Daawo cusub oo la yiraahdo Patiromer ayaa muujisay balanqaad lagu daaweynayo hyperkalemia ee dadka qaata nidaamka renin-angiotensin-aldosterone (RAAS). Cudurka hyperkalemia waa nolol halis ah wuxuuna keenaa daciifnimo, kor u kicinta curyaanka, neefsashada neefsiga, iyo cilladaha wadnaha.
Mararka qaarkood, dadku waxay la qabaan hyperkalemia, ama heerarka sare ee potassium ee dhiigga, ee xarumaha bukaan socodka.
Dadkaas ayaa ah kuwo ka weyn oo badanaaba qaba cudurka kelyaha ee macaanka oo ay la socdaan hyperkalemia ka dib markii ay qaadeen nidaamka renin-angiotensin-aldosterone (RAAS) inhibitorsayaasha (β-blockers, angiotensin-converting enzyme inhibitors, angiotensin reseptor blockers [ARBs], iyo antagonists alertosterone) Bukaannada noocaas ah ee qaba naafonimada asaasiga ah ama macaanka neerfaha, macdanta potassium waxaa lagu kordhin karaa heerarka khatarta ah kadib marka la maamulo daawooyinka RAAS, taas oo ka dhigeysa potassium ka soo kaadida kaadida.
Badanaa, hase yeeshee, hyperkalemia waa wax aad u badan oo soo bandhigaya bukaanada isbitaalada leh ee lagu daaweeyo RAAS inhibitorsada wadnaha oo ku fashilma wadnaha, sonkorow, iyo cudur kili ah oo joogta ah. Sonkorowga iyo cudurrada kalyaha ee joogtada ah waxay keenaan atherosclerosis iyo glomerulosclerosis, siday u kala horreeyaan; geeddi-socodka cudurada wadnaha ayaa si wadajir ah u wada shaqeynaya si loo xakameeyo awooda jidhka (kelyaha) ee awoodda u leh in laga takhaluso potassium.
Inkastoo inhibitorayaasha RAAS yihiin potassium-sparing waxayna keeni karaan heerar sare oo ah potassium ama hyperkalemia, wadnaha oo aan shaqeynin, cudur kelyo joogta ah iyo sonkorowga ayaa lagu daaweeyaa ka hortagga RAAS. Sidaa darteed, waxay noqon kartaa mid waxtar leh si loo helo hab waxtar leh oo lagu daaweyn karo hyperkalemia ee dadka qaba xaaladdahan kuwaas oo qaadanaya xanuunka RAAS.
Xilligan, hyperkalemia waxaa lagu daaweeyaa oo kaliya tallaabooyin ku-meel-gaadh ah sida xanuunka beta, kalsiyum, ama insulin iyo glucose, kuwaas oo dhammaantood ku dhex jira unugyada; loop ama thiazide diuretics, labadaba kuwaas oo ah dhadhanka potassium waxayna kordhiyaan qashinka potassium; daroogo loo yaqaan 'sodium polystyrene sulfonate' (Kayexalate), taas oo keeni karta hypomagnesemia, hypokalemia, xanuunka caloosha ee daran iyo xitaa necrosis mindhicirka; iyo sifeynta. Inta lagu jiro Wejiga 3aad ee kiliinikada, Patiromer waxay si weyn u yareyneysaa heerarka potassium ee bukaanada leh cudurka kelyaha ee cudurka macaanka kuwaas oo qaadanayay xanuunka RAAS waxayna sameeyeen khafiif ah illaa hyperkalemia.
Patiromer waxaa laga sameeyaa polymer kaas oo ka gudbo mareenka caloosha iyo mindhicirka. Marka ay maraan mareenka caloosha iyo mindhicirrada, waxay ku ridi kartaa potassium. Baadhitaanada bukaan-socodka, Patiromer ayaa lagu muujiyay inay tahay ammaan iyo waxtar dhan 52 toddobaad ee dadka qaba hyperkalemia iyo sokorowga, taas oo muujineysa in ay tahay daaweyn dayactir ah oo rajo leh. Si kale haddii loo dhigo, dadka qaadaya xanuunka RAAS waxay ka fogaan karaan dhiig-karka (Hyperkalemia) iyagoo qaadanaya Patiromer. Intaa ka sokow, markii ka-qaybgalayaashu joojiyeen qaadashada cudurka Patiromer, waxay si dhaqso ah u sameeyeen dhiig-kicida mar kale. Daraasad la xidhiidha, cilmibaaris kale, Patiromer ayaa sidoo kale lagu muujiyey inay ka hortagtay hyperkalemia dadka qaba wadnaha oo aan shaqaynin kuwaas oo qaadanayay xanuunka RAAS.
Bukaanleyda qaadata Patiromer waxay soo wargeliyeen qaar ka mid ah dhibaatooyinka laxiriirta oo ay ka mid yihiin ka sii darista cudurrada kalyaha ee ba'an, hypomagnesemia, ka sii darista dhiig-karka iyo xanuunka caloosha. Guud ahaan, si kastaba ha ahaatee, boqolkiiba 10 oo ka mid ah ka qaybgalayaasha daraasaddan ayaa joojiyay qaadashada cudurka Patiromer sababtoo ah dhibaatooyinkaas xun.
Inkasta oo ballan-qaadkii uu muujiyay Patiromer inta lagu guda jiro Wajiga 3 - da ee kiliinikada , khubarada qaarkood ayaa ka hadlay dareenka daroogada. Marka hore, khubaradaasi waxay tilmaamayaan in ay noqon doonto fikrad wanaagsan in la sii wado baaritaanka Patiromer mudo ka badan sanad - ka dib, dadka qaarkood waxay u baahnaan doonaan in inta dhiman ee noloshooda ay ku qaataan Patiromer inta ay qaadanayaan xanuunka RAAS.
Marka labaad, ma cadda in dadka ay qaataan RAAS inhibitorsada iyo Patiromer loogu talagalay faa'iidada hyperkalemia ee daaweynta ka hortagga RAAS sida badan kuwa qaba heerarka caadiga ah ee potassium (normokalemia) kuwaas oo qaadanaya xanuunka RAAS.
Haddii aad qabtid wax su'aalo ah oo ku saabsan Patiromer ama wax daawo ah, fadlan samee ballan si aad ugala hadasho cabashooyinkaa dhakhtarkaaga. Fadlan xusuuso in dhakhtarkaagu yahay daryeele naxariis leh oo ujeedkiisu yahay inuu kaa caawiyo inaad sii wado aqoonta iyo wargelinta. Akhrinta ku saabsan daroogada iyo daaweynta internetka waa hab aad u wanaagsan oo lagugu wargeliyo. Si kastaba ha ahaatee, aqoonkani waa inuu dhammeystiraa daryeelka iyo talada ay bixiso takhtarkaaga.
> Ilo:
> "Saamaynta Kacdoonaha Qaybta Serum Potassium ee bukaanka qaba Cudurka Hyperkalemia iyo Cudurka Kelyaha ee Diabetes AMETHYST-DN Trial Clinical Trial" by GL Bakris iyo qorayaasha la daabacay JAMA ee 2015.
> "Daaweynta Hyperkalemia Laga bilaabo" Hyper K + "Strikeout ilaa Guriga Run?" by WC Winklemayer lagu daabacay JAMA ee 2015.