ObjectiveTo summarize the perioperative management experience and the treatment strategy of hyperkalemia after simultaneous pancreas and kidney transplantation (SPK).MethodThe clinical data of patients with diabetes combined with end-stage renal disease who accepted SPK in the Organ Transplantation Center of West China Hospital of Sichuan University from November 2017 to November 2019 were retrospectively analyzed.ResultsA total of 6 patients accepted SPK totally. The cold ischemia time of all allografts was less than 8 h. The levels of fasting blood glucose and serum creatinine were normal in the 5 surviving patients, and the diabetic complications were relieved or improved, except for 1 patient who died of cardiac arrest due to acute left heart failure. There were 1 case of delayed primary renal function recovery, 2 cases of bleeding in the surgical area of pancreas transplantation, 1 case of gastrointestinal bleeding, 3 cases of microthrombosis in the blood vessels of pancreas transplantation, 2 cases of perirenal effusion infection, 2 cases of pulmonary infection, and 1 case of ureterobladder anastomotic leakage, all of which were cured after symptomatic treatment. Only 2 patients occurred hyperkalemia after SPK (the highest level was 6.49 mmol/L and 6.67 mmol/L respectively), and transfusion of 10% glucose injection contain insulin, emergency dialysis and oral fludrocortisone were successively performed on them to restore the potassium density in 1 month and 2 months after surgery. There were no complications of perioperative surgical technical hemorrhage, intestinal leakage, large arteriovenous thrombosis, necrotizing pancreatitis, etc.ConclusionsSPK is the most effective treatment for patients with diabetes combined with end-stage renal disease. Transfusion of 10% glucose injection contain insulin, emergency dialysis, and oral fludrocortisone are effective strategies in treating hyperkalemia after SPK.
ObjectiveTo understand the research progress of treatment of hyperkalemia after simultaneous pancreas and kidney transplantation (SPK), and to provide the basis for the prevention and treatment of hyperkalemia after SPK.MethodThe relevant literatures about hyperkalemia after SPK in recent years were reviewed.ResultsThe pancreas and kidney that maintained the stability of serum potassium in different ways had been confirmed in current studies. The newly transplanted organ dysfunction after SPK and the use of drugs after SPK both caused hyperkalemia. The treatment principle of hyperkalemia after SPK was to take corresponding prevention and treatment measures according to different reasons.ConclusionsSPK is the best treatment for diabetic renal failure. Postoperative hyperkalemia is one of the most common complications, and timely and correct management is of great significance to the survival and prognosis of patients.
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.