【摘要】 目的 血管紧张素受体拮抗剂（angiotension Ⅱ receptor blockers，ARB）是血液透析患者常用的降压药物之一，可对肾脏的排钾功能产生影响。研究通过对血液透析患者高钾血症的发生情况进行调查，了解并分析相关影响因素，探讨ARB类药物在血液透析患者中应用的安全性。 方法 2010年1月－2010年7月对95例维持性血液透析患者的临床资料进行调查，比较ARB组和非ARB组高钾血症的发生率，并将可能的危险因素和高钾血症的发生率进行相关性分析。 结果 纳入患者中使用ARB类降压药47例，未使用ARB类降压药48例。ARB组高钾血症15例（31.9%），非ARB组高钾血症14例（29.2%），发生率无统计学意义（Pgt;0.05）。将高钾患者和血钾正常患者做对比，高钾血症组年龄较轻[（47.69±13.64）岁，（54.50±13.54）岁；Plt;0.05]，尿量lt;400 mL者所占比例更大（89.7%，57.6%；Plt;0.05）。logistic回归分析结果显示，高钾血症的发生与年龄、透析次数、尿量相关，而与ARB药物的使用无关。 结论 血液透析患者高钾血症的发生与患者的透析次数、尿量、年龄相关，ARB类药物的使用未增加高钾血症的发生率。【Abstract】 Objective To analyze the risk factors for hyperkalemia and evaluate the security of ARBs application in hemodialysis patients, as angiotensin Ⅱ receptor blockers (ARBs) are commonly used anti-hypertensive drugs in hemodialysis patients, and they may affect the renal excretion of potassium. Methods The clinical data of 95 hemodialysis patients were investigated from January 2010 to July 2010. We compared the incidence of hyperkalemia in ARBs group and non-ARBs group, and also analyzed the correlation between the possible risk factors and hyperkalemia incidence. Results There were 47 patients in the ARBs group and 48 patients in the non-ARBs group. Fifteen patients (31.9%) in the ARBs group and 14 (29.2%) in the non-ARBs group had hyperkalemia, and there was no significant difference in the proportion of patients who had hyperkalemia between the two groups (Pgt;0.05). Compared with patients without hyperkalemia, patients with hyperkalemia were younger [(47.69±13.64) vs. (54.50±13.54) years, Plt;0.05], and more often had urine volume less than 400 mL (89.7% vs. 57.6%, Plt;0.05). Logistic regression analysis showed that the incidence of hyperkalemia was related to age, frequency of dialysis, and urine volume, not to ARBs. Conclusion The incidence of hyperkalemia in hemodialysis patients is related to the frequency of dialysis, urine volume and age; ARBs do not increase the incidence of hyperkalemia.
Objective To analyze the research hotspots and trends in the field of hyperkalemia in hemodialysis patients at home and abroad, and to provide reference for the research and prevention and control of hyperkalemia in hemodialysis patients. Methods China National Knowledge Infrastructure (CNKI) and Web of Science databases were searched by computer for literature about the hyperkalemia in hemodialysis patients published between January 1995 and January 2023. The included literature was analyzed using visualization analysis tools for visualization, including high-frequency keywords, keyword co-occurrence map, keyword emergence intensity and keyword time series prediction. Results A total of 10 275 articles were included. Among them, there were 10 036 articles from web of science and 239 articles from CNKI. The number of articles in this research field showed a trend of steady increase year by year. The United States was in a leading position in the research and development in this field, followed by China. At the same time, the research in this field presents the characteristics of multidisciplinary integration. The development trends of research hotspots in the next 5 years were risk and health education research. Conclusions The number of research articles related to hyperkalemia in hemodialysis patients is gradually increasing. Multidisciplinary approach and integration is a research hotspot and frontier in the development of hyperkalemia in hemodialysis patients both domestically and internationally.