关键词: 肾透析, 高钾血症, 饮食习惯, 聚苯乙烯磺酸钙

Abstract: Background　Hyperkalemia is a common complication of maintenance hemodialysis patients,and its excessive volatility of serum potassium during hemodialysis interphase is likely to increase the risk of adverse cardiovascular events,therefore,how to maintain stable serum potassium level during hemodialysis interphase is very important.Objective　To compare the clinical effects of simple low-potassium diet and low-potassium diet combined with small doses of calcium polystyrene sulfonate on treating hyperkalemia of maintenance hemodialysis patients.Methods　According to inclusion criteria,52 patients who underwent maintenance hemodialysis in Hemodialysis Room of the First Affiliated Hospital of Xiamen University from December 2015 to January 2016 were retrospectively selected with serum potassium level≥5.0 mmol/L before hemodialysis.Patients were assigned into control group with 21 cases and research group with 31 cases based on their medication status.Patients in control group received simple low-potassium diet,based on which patients in research group were treated with oral medication of small doses of calcium polystyrene sulfonate.With continuous treatment,patients in two groups were given relevant checks one month after treatment.Serum potassium levels before and after hemodialysis and their difference value,serum calcium before hemodialysis and albumin （Alb） levels of petients in two groups were recorded before and after treatment.Results　Serum potassium levels of all patients before and after hemodialysis and their difference value after treatment were lower than those before treatment （P<0.05）;serum calcium before hemodialysis and Alb levels of all patients before and after treatment were not significantly different （P>0.05）.Before treatment,serum potassium level before and after hemodialysis and their difference value,serum calcium before hemodialysis and Alb levels among patients in two groups were not significantly different （P>0.05）;after treatment,serum potassium level before hemodialysis and difference value of serum potassium levels before and after hemodialysis of patients in research group were significantly lower than those in control group （P<0.05）;after treatment,serum potassium level after hemodialysis,serum calcium before hemodialysis and Alb levels of patients in two groups were not significantly different （P>0.05）.Serum potassium level before hemodialysis and difference value of serum potassium levels before and after hemodialysis of patients in control group after treatment were lower than those before treatment （P<0.05）;there were no significant differences in serum potassium level after hemodialysis,and serum calcium before hemodialysis and Alb levels of patients in control group before and after treatment （P>0.05）;serum potassium levels before and after hemodialysis and their difference value of patients in research group after treatment were lower than those before treatment （P<0.05）;serum calcium before hemodialysis and Alb levels of patients in research group before and after treatment were not significantly different （P>0.05）.Conclusion　Simple low-potassium diet or low-potassium diet combined with small doses of calcium polystyrene sulfonate can reduce hemodialysis patients’ serum potassium level before hematodialysis and reduce potassium volatility,moreover the effects of low-potassium diet combined with small doses of calcium polystyrene sulfonate on lowering potassium is better than those of simple low-potassium diet without increasing calcium load of patients.

Key words: Renal dialysis, Hyperkalemia, Dietary habits, Calcium polystyreme sulphonate