2022 年第 12 期 第 17 卷

环硅酸锆钠散治疗慢性高钾血症1例

A case of chronic hyperkalemia treated with sodium zirconium cyclosilicate powder

作者：刘环1罗琰琨2王晨丹2

英文作者：Liu Huan1 Luo Yankun2 Wang Chendan2

单位：1山西医科大学第五临床医学院肾内科，太原030002；2山西省人民医院肾内科，太原030002

英文单位：1Department of Nephrology the Fifth Clinical Medical College of Shanxi Medical University Taiyuan 030002 China; 2Department of Nephrology Shanxi Provincial People′s Hospital Taiyuan 030002 China

关键词：高钾血症；慢性肾脏病；环硅酸锆钠散

英文关键词：Hyperkalemia;Chronickidneydisease;Sodiumzirconiumcyclosilicatepowder

• 摘要：

• 1例55岁女性患者因“反复高钾血症2年，全身抽搐1 d”入院。患者2年前诊断为慢性肾脏病，近2年多次出现恶心、呕吐及双足、双小腿麻木不适等症状，血钾水平波动于4.50~7.14 mmol/L。入院前1天出现全身抽搐，血肌酐715.71 μmol/L，血钾6.18 mmol/L。入院时血钾6.64 mmol/L、血肌酐690.51 μmol/L、空腹血糖8.6 mmol/L。完善检查后诊断为慢性肾脏病，高钾血症，糖尿病肾病，2型糖尿病，糖尿病视网膜病变，高血压。予静脉注射葡萄糖+胰岛素、呋塞米、碳酸氢钠，口服环硅酸锆钠散等对症治疗。患者住院期间血钾水平维持在正常范围内。出院后随访1年，患者未再出现高钾血症。

• A 55-year-old female patient was admitted to hospital for "recurrent hyperkalemia for 2 years and systemic convulsions for 1 d". The patient had been diagnosed with chronic kidney disease 2 years ago and suffered from nausea, vomiting and discomfort and numbness in both lower legs anf feet for nearly 2 years. The level of serum potassium fluctuated was 4.50-7.14 mmol/L. She had generalized convulsions 1 d before admission, with serum creatinine 715.71 μmol/L and serum potassium 6.18 mmol/L. On admission, serum potassium was 6.64 mmol/L, serum creatinine was 690.51 μmol/L and fasting blood glucose was 8.6 mmol/L. After examination, she was diagnosed as chronic kidney disease, hyperkalemia, diabetic nephropathy, type 2 diabetes mellitus, diabetic retinopathy and hypertension. Symptomatic treatment such as intravenous injection of glucose+insulin, furosemide and sodium bicarbonate, and oral sodium zirconium cyclosilicate powder was given. The serum potassium level of the patient remained within the normal range during hospitalization. The patient was followed-up for 1 year after discharge, and there was no hyperkalemia.