Hyperkalemia an gano shi a lokacin da magani dinka na potassium yayi matakan 5.0 mEq / L ko fiye. Ana iya haifuwa ta hanyar ingestion da yawa daga potassium, ba tare da rage yawan potassium ba, ko kuma ta hanyar potassium tacewa daga sel.
Gwajiza zai iya taimakawa wajen sanin wane daga cikin wadannan sassan da ke haifar da babban potassium. Sai kawai lokacin da ka san dalilin da yasa kake da hyperkalemia zaka iya bi da shi yadda ya dace kuma da fatan hana rikicewa.
Gwajin jini
Kafin ka sauko hanyar hanyar gwaji, likitanka zai so ka tabbata kana da hyperkalemia na gaskiya. Sau da yawa, matakan potassium suna da girman maɗaukaki, yanayin da aka sani da pseudohyperkalemia, saboda yadda yaduwar jininka yake .
Wani abincin da aka yi amfani dashi sosai ko tsayi yana iya haifar da yaduwar jini don yaduwa ko fashe, yayata potassium a cikin samfurin. Maimaita tsararren yatsun hannu a yayin da ake zubar da ruwa zai iya haifar da potassium daga jikinka, kara yawan sakamakon layinka kamar yadda 1 zuwa 2 mEq / L.
Maganin likitanku na farko shi ne sake duba matakin potassium. Idan matakanka ya kasance high, likita na iya yin umarni da gwaje-gwaje na gaba.
Gwaje-gwaje na farko
Rashin ƙarfin renal , ko yana da muni ko na yau da kullum, yana daya daga cikin abubuwan da ya fi dacewa ta hanyar hyperkalemia. Lokacin da kodan sun gaza, ba su da ikon hazari potassium yadda ya kamata. Wannan zai haifar da ginawa na potassium a cikin jini.
Urea nitrogen na urea (BUN) da kuma creatinine auna yadda yadda kodanka ke aiki kuma an haɗa su a matsayin ɓangare na mahimman tsari. Wasu gwaje-gwaje a cikin panel sun haɗa da sodium, chloride, bicarbonate, da glucose. Ana amfani da waɗannan ma'auni na ƙididdigar ɓangaren gado wanda, idan aka haɓaka, yana nuna metabolic acidosis.
Acidosis iya jawo potassium daga cikin sel kuma cikin jini. Matakan glucose masu girma, kamar yadda za'a iya ganin su a cikin ciwon sukari marasa rinjaye , na iya yin haka. Ƙananan matakan sodium a fuskar matakan high potassium zasu iya bayar da shawarar yanayin yanayin hormonal da ake kira hypoaldosteronism.
Ƙididdigar jini cikakke zai iya kasancewa gwajin gwajin taimako. Halin jini yana iya zama alamar kamuwa da cuta ko ƙumburi a cikin jiki. Ƙananar haemoglobin da ma'aunin hematocin suna nuna anemia. Abun da cutar ta haifar da raunin jini, wanda aka fi sani da anemia mai yaduwa , zai iya saki manyan matakan potassium cikin jini.
- BUN
- Creatinine
- Kungiyar kwakwalwa
- Kammala ƙimar jini
Tambayoyi na musamman
Dangane da lafiyarku da tarihin likita, likitanku na iya zabar bin wasu daga cikin gwaje-gwaje masu zuwa.
- Aldosterone: Aldosterone wani hormone ne wanda glandar da ke jikinta ke haifar da karfin jini. Ko da ma matakan potassium sun yi yawa kuma matakan sodium suna da ƙasa, an buƙatar matakin aldosterone don tabbatar da ganewar asali na hypoaldosteronism. Har ila yau, jimlawar mahimmanci ne tare da yanayin.
- Creatinine phosphokinase (CPK): Babban matakan CPK sun nuna cewa akwai rauni ga tsokoki. Ba wai kawai wannan ilimin enzyme yake fita daga cikin tsokoki ba amma zai iya rufe kodan, wanda zai haifar da gazawar koda a abin da ake kira rhabdomyolysis . Har ila yau, Potassium yana fita daga cikin tsoka.
- Matakan Digoxin: Digoxin yana daya daga magunguna da yawa zasu iya samun sakamako na gaba na hyperkalemia. Ba kamar beta-blockers wanda kuma iya ƙara magani potassium, digoxin yana da gwaji jini don duba yawan magani ne a cikin jini.
- Uric acid da phosphorus gwaje-gwaje: Lokacin da kwayoyin halitta suka rushe, sun saki uric acid da phosphorus banda potassium. Wannan na iya faruwa ne a cikin anemia mai haɗari ko ƙuƙwalwar ƙwayar cuta na sikila. Haka kuma zai iya faruwa a cikin ciwon huhu na lysis lokacin da akwai mummunar ɓarkewar sel bayan chemotherapy.
Gwajin Urine
Kyakkyawan aikin gaggawa yana kallon jini, glucose, furotin, ko kamuwa da cutar cikin fitsari.
Abubuwa masu ban sha'awa zasu iya nuna ciwon jini, kumburi da koda, ko glomerulonephrosis, yanayin rashin jinin ƙwayar inda koda yake farfadowa da furotin. Har ila yau yana iya nuna ciwon sukari wanda ba shi da kariya.
Za a iya biyan gwaje-gwajen ƙin gaggawa ta musamman don bincika yadda kodan suna aiki. Idan amine na potassium da sodium suna cikin iyakokin da aka sa ran, kodan baya da laifi. Dole ne a bincika wani abu marar yaduwa. Jaraba don fitsari myoglobin iya tabbatar da ganewar asali na rhabdomyolysis.
- Basic urinalysis
- Urine potassium da sodium
- Urin myoglobin
Kwalejin Cardiac
Hyperkalemia zai iya haifar da arrhythmias na rayuwa idan matakan potassium ɗinka sun yi yawa. Wani electrocardiogram (ECG) wani abu ne mai mahimmanci na bincike, ba kawai don gano wasu lokutta masu tsanani na hyperkalemia ba amma don gano ko wane nau'in arrhythmia yake.
Kwararru ta ECG tana ƙaddamar da motsi ta lantarki ta hanyar zuciya, daga ɗakunan ɗakunan zuciya, da atria, zuwa ɗakunan tsakiya, da ventricles. Kowane layi a kan ECG daga PQRST yana wakiltar kunnawa ko dawo da wani ɗaki daban-daban na ƙwayar zuciya.
Kamar yadda magani na potassium yayi ƙaruwa, sauyin ECG ya zama mafi tsanani. Farawa a matakan 5.5 meq / L da sama, ƙwararrun ventricles na da wahala ta dawowa. Ana iya ganin hakan a matsayin mai tasowa a kan ECG. An yi tasiri a kunne a kan 6.5 mEq / L don a iya ganin rudun p-p. A 7.0 mEq / L, raƙuman QRS sun kara girma, daidai da jinkirin kunna ventricles.
Cardiac arrhythmias sukan ci gaba a 8.0 mEq / L. Wannan zai iya hada dukkanin abubuwa daga sinus bradycardia zuwa ventricular tachycardia . A cikin mafi munin yanayi, lalacewar, asarar duk wani motsi na lantarki, zai iya faruwa. Yayin da ECG ba ta tantance hanyar hyperkalemia ba, yana nuna tsananin da yanayin. Cardioc arrhythmias yana buƙatar magani na gaggawa.
Binciken Bambanci
Mutanen da ke da cirrhosis, rashin ciwowar zuciya , da kuma ciwon sukari suna fuskantar haɗari ga bunkasa hyperkalemia. Sauran yanayin da ke ci gaba da kasancewa a ciki shine amyloidosis da cututtukan ciwon sikila .
Idan an umarce ka da magunguna kamar masu maganin ACE, masu satar kaya angiotensin-receptors, beta-blockers , cyclosporine, digoxin, minoxidil, spironolactone, da tacrolimus, ku sani cewa matakan potassium ku iya karuwa. Kwararka na iya neman wasu abubuwan da ke haifar da hyperkalemia, kamar ƙananan raguwa da hypoaldosteronism, kamar yadda aka tsara a sama.
> Sources:
> Kehnhardt A, Kemper MJ. Bincike, Fahimtarwa da Gudanarwa na Hyperkalemia. Pediatr Nefrol. 2011 Mar; 26 (3): 377-384. Doi: 10.1007 / s00467-010-1699-3.
> Levis JT. ECG ganewar asali: Hyperkalemia. Perm J. 2013 Yara; 17 (1): 69.doi: 10.7812 / TPP / 12-088
> Lewis JL. Hyperkalemia. Merck Manual: Jagoran Mai Sake. Updated Afrilu 2016. https://www.merckmanuals.com/professional/endocrine-and-metabolic-disorders/electrolyte-disorders/hyperkalemia.
> Dutsen Dutsen. Dalili da Bincike na Hyperkalemia a cikin Adult. A cikin: Forman JP (ed), UpToDate [Intanit] , Waltham, MA. Updated Fabrairu 2018.
> Simon LV, Farrell MW. Hyperkalemia. A cikin: Lambobin Bayani [Intanit]. Ƙarƙashin Ƙasa (FL): Lambobin Bayyanawa. 2018 Janairu.