Hyperkalemia waa ereyga caafimaadka ee heerarka potassium-ka ee aad u sarreeya. Potassium waa unug kiimiko ah oo muhiim u ah nolosha. Waxaa si gaar ah muhiim ugu ah hawlaha caadiga ah ee nidaamka unugyada kuwaas oo ku tiirsan gudbinta calaamadaha korantada - wadnaha, muruqyada, iyo dareemayaasha. Waxaa jira waxyaabo badan iyo cuduro keeni kara hyperkalemia, oo ay ku jiraan cudurka kelyaha, wadnaha oo ku fashilmay, sonkorow, iyo daawooyinka qaarkood.
Dadka qaangaarka ah, heerka caadiga ah ee heerka potassium wuxuu u dhexeeyaa 3.6 iyo 5.2 mEq / L. Heerarka potassium oo aad u hooseeya (hypokalemia) ama aad u sarreeya waxay noqon kartaa dhibaatooyin nolosha halis gelin kara.
Sababaha Caadi ahaaneed
Waxaa jira sababo badan oo suurtagal ah ee keena hyperkalemia, laakiin waxaa loo jajabin karaa saddex qaybood oo waaweyn.
Hoosudhaca Qaadashada Potassium
Sababtoo ah ilaalinta heerarka caadiga ah ee potassium waa mid muhiim u ah nolosha, kelyahaagu waxay leeyihiin habab wax ku ool ah oo loogu talagalay potassium si looga hortago heerarkeenna in ay aad u hooseeyaan, iyo sidoo kale in lagu dhuuqo potassium ka badan ee kaadida si looga hortago heerarkayaga in aan aad u sarreeyo. Si kastaba ha noqotee, iyadoo kelyo xanuun daran ama cudurrada kalyaha ee joogtada ah , awoodda kelyaha si ay potassium ka soo baxdo inta badan waxay noqon kartaa mid liidata, iyo hyperkalemia ayaa laga yaabaa inay noqoto. Ka hor intaan la gaarin sanka sifaynta , hyperkalemia waxay ahayd sabab u badan dhimashada dadka qaba cudurka kalyaha.
Hoos-u-dhac ku yimaada qashinka kelyaha ee potassium ayaa sidoo kale laga yaabaa inuu ku dhaco:
- Cudurka Addison (Dhibaatada qanjirrada adrenal)
- Wadnaha oo ku fashilmay wadnaha
- Cirrhosis ee beerka
- Daawooyinka qaarkood ee saameeya nidaamka renin-aldosterone oo ay ka mid yihiin angiotensin-converting enzyme (ACE) , daawooyinka anjiotensin II , daawooyinka nonsteroidal antiinflammatory (NSAIDs), calcineurin inhibitors, heparin, iyo diiretics-ka dhalaalaya potassium-diiretics sida Aldactone iyo Carospir ( spironolactone ) iyo Inspra (eplerenone)
Kordhinta Kaluunka ee Kansarka
Sababtoo ah foojignaanta potassium gudaha unugyada jirkaaga waa qiyaas ahaan 30 jeer ka sarreeya dhiiggaaga, wax kasta oo keena sii kordhinta potassium gudaha unugyada gudaha dibedda unugyada ayaa keeni kara hyperkalemia. Marka jirkaaga ka kooban yahay aashit aad u badan, oo loo yaqaan acidosis, sida sonkorowga ketoacidosis , potassium ayaa laga soo saaraa unugyadaada wuxuuna soo saari karaa halis ah oo suuragal ah in uu ku dhaco hindhis-ku-noolaansho nolosha.
Dhibaatada cadka ayaa sidoo kale soo saari kara shamiin potassium gudaha gudaha unugyada gudaha dibedda unugyada, si fudud oo ay u dhejiso xuubabka unugyada jaban. Hyperkalemia waxyeellada unugyada waxay ku dhici kartaa nooc kasta oo ah dhaawacyo daran, gubasho, qalliin, burbur degdeg ah oo unugyada tumo, dhiigkarka dhiigga ee dhiigga , ama dhiig-baxa , jabinta unugyada muruqyada oo ku dhici kara istarooga kuleylka , ama qaawan khamriga ama daroogada .
Sababaha kale ee suurtogalka ah ee sii kordhaya ee potassium ka soo unugyada jirkaada waxaa ka mid ah:
- Insulin la'aanta oo keenta hyperglycemia (sonkorta dhiiga badan ee dhiigaaga), sida waxay ku dhici kartaa sonkorowga aan fiicnayn ama aan la kontoroolin
- Insulin la'aantu waxay sabab u tahay soonka, gaar ahaan dadka ku jira sifeynta
- Insulin la'aanta ka qaadashada somatostatin ama Sandostatin (octreotide), hormoonnada oo xannibaya hormoonnada koritaanka
- Tumor lysis syndrome, oo dhici karta haddii aad qabtid lymfoma ama leukemia iyo lagu siiyo daaweynta kemotherabi ama daaweynta shucaaca
- Beta blockers
- Ku-shubid dhiig
Isticmaal xad dhaaf ah ee Potassium
Haddii aad caadi ahaan kelyo qabtid, aad ayay u adagtahay in la hormariyo hyperkalemia si fudud inaad ka qaadato potassium aad u badan cuntadaada. Si kastaba ha ahaatee, waxaa suurtagal ah in aad qaaddo heerarka potassium-ka dhiig aad u sarreeya haddii aad qaadato xaddi badan oo ka mid ah daawooyinka potassium, gaar ahaan haddii aad leedahay xitaa heerka qaaxada ee kalyaha, ama haddii aad qaadatid daroogo ku xakameysa qashinka potassium sida kuwa kor ku xusan.
Genetics
Waxaa jira laba cudur oo dhif ah oo la iska dhaxlo oo keeni kara hyperkalemia. Kuwani labadaba waxaa lagu ogaan karaa baaritaanka hidda-socodka.
Pseudohypoaldosteronism Nooca 1
Nooca Pseudohypoaldosteronism nooca 1 (PHA1) wuxuu adkeynayaa jirkaaga si uu u xakameeyo sodium, taas oo inta badan ku dhacda kelyahaaga. Waxaa jira laba nooc oo ah PHA1: automomal dominant PHA1, oo ah mid sahlan oo caadi ahaan hagaajiya inta lagu jiro carruurnimada, iyo autosomal resecision PHA1, taas oo ah mid aad u daran oo aan fiicneyn. Cudurkaan wuxuu keeni karaa hyperkalemia sababtoo ah xaddi badan oo sodium ah ayaa lagu sii daayaa kaadidaada, taas oo keeneysa heerar hoose oo ah sodium iyo heerarka sare ee potassium ee dhiiggaaga. Xaqiiqdii, hyperkalemia waxaa loo tixgeliyaa mid ka mid ah waxyaabaha ugu muhiimsan ee cudurkan.
Nooca 1 ee Pseudohypoaldosteronism waxaa keena isbeddellada mid ka mid ah afarta naqshadood oo saameeya xakamaynta sodiumka. Xubnahan waxaa ka mid ah NR3C2 (hiddaha keena automomal dominant PHA1), SCNN1A, SCNN1B, ama SCNN1G, taas oo keenta autosomal recai PHA1. Xaaladdani waxay saameyneysaa qiyaastii 1 qof 80,000 oo carruur ah oo dhashay ilmaha.
Pseudohypoaldosteronism Nooca 2
Pseudohypoaldosteronism nooca 2 (PHA2), oo loo yaqaan 'Gordon's syndrome', waa xaalad kale oo la iska dhaxlo oo keena hyperkalemia. Cudurkan ayaa adkeynaya jidhkaaga si uu u xakameeyo soodhiyamka iyo potassium labadaba, oo keena cadaadiska dhiigga sareeya iyo hyperkalemia, laakiin shaqeyn kelyo caadi ah. Hyperkalemia waxay u eg tahay inay marka hore dhacdo, halka cadaadiska dhiigga oo sareeya uu sii kordho.
PHA2 waxaa sababa isbeddelada WNK1, WNK4, CUL3, ama KLHL3 gene, kuwaas oo dhammaantood ka caawiya inay cadaadiyaan cadaadiska dhiigga. Tani sidoo kale waa cillad naadir ah, laakiin lama yaqaan inta jeer ee PHA2 dhacdo.
Wadne-qabatin
Qalabka wadnaha ee qalalaasaha ayaa loo tixgeliyaa mid ka mid ah sababaha keena hyperkalemia, sida qaar ka mid ah daawooyinka dadka qaba wadne qabadka wadnuhu inta badan qaataan, oo ay ku jiraan diuretics, ACE inhibitor, iyo beta blockers. Sidaa daraadeed, haddii aad qabtid wadne-istaagid qalalaaso oo aad qaadato mid ka mid ah daawooyinkan badbaadada nolosha, waxaa laga yaabaa inaad u baahato inaad xaddido qadarka potassium aad ku leedahay cuntadaada si loo yareeyo khatarta ah inuu kugu dhaco hyperkalemia. Dhakhtarkaagu wuxuu u maleynayaa inuu sidoo kale kormeerayo heerarka potassium ee dhiiggaaga oo hubi inaad ku jirto qadarka ugu yar ee noocyada daroogada kaasoo keena heerarka potassium si loo kordhiyo.
Ciladaha Halista ee Hab-nololeedka
Haddii aad qabto sonkorow, waxaa ka mid ah sababo badan oo muhiim u ah in cudurka lagaa ilaaliyo ay tahay halista ah in uu ku dhaco hyperkalemia, taas oo keeni karta dhimasho haddii uu noqdo mid daran. Marka sonkorowgaagu uu si xun u kontoroolo ama aan loo xakameynin, waxaad la kulantaa sonkorta dhiiga badan ee ku jirta dhiiggaaga, adigoo abuuraya insulin yaraanta oo keeni karta hyperkalemia iyo dhibaatooyinka kale ee nafta khatar geliya. U hubso inaad la shaqeyso dhakhtarkaaga si aad u heshid barnaamij daaweyn oo kaaga shaqeynaya xakamaynta gulukooska dhiiggaaga si aad u yareyn karto khatarahaaga halisaha, halisaha nolosha, khataraha.
> Ilo:
> Genetics Home Tixraac. Pseudohypoaldosteronism Nooca 1. Machadyada Qaranka ee Caafimaadka. Maktabadda Qaranka ee Dawada ee Maraykanka. La daabacay Abriil 25, 2018.
> Genetics Home Tixraac. Pseudohypoaldosteronism Nooca 2. Machadyada Qaranka ee Caafimaadka. Maktabadda Qaranka ee Dawada ee Maraykanka. La daabacay Abriil 25, 2018.
> Mayo Clinic Staff. Potassium High (Hyperkalemia). Mayo Clinic. La daabacay Janaayo 11, 2018.
> Buugga DB. Sababaha iyo Qiimeynta Hyperkalemia ee Dadka Qaangaarka ah. UpToDate. La daabacay Juun 5, 2017.
> Sterns RH, Rojas M, Bernstein P, Chennupati S. Ion-Isku Bedelashada Daaweynta Hyperkalemia: Miyey Amaan yihiin? Wargeyska Jarmalka Nephrology . May 2010; 21 (5): 733-5. doi: 10.1681 / ASN2000079.