CLINICAL ASPECTS OF HYPERKALIEMIA IN MODERN CARDIOLOGICAL PRACTICE

Miakinkova L. O., Toronchenko O. M.

LITERATURE REVIEWS

Scentific article

Hyperkalemia is an electrolyte disorder with potentially life-threatening consequences such as fatal arrhythmias. The main causes of hyperkalemia are conditions that lead to a decrease in potassium excretion and conditions that promote the movement of intracellular potassium into the extracellular space. Separately, iatrogenic hyperkalemia and pseudohyperkalemia should be distinguished. Hyperkalemia is particularly common in metabolic acidosis, insulin deficiency, hyperglycemia, hyperosmolar states. Medicines such as inhibitors of the renin-angiotensin-aldosterone system can increase potassium levels. Therefore, the establishment of the etiological factor is the first step in the examination of a patient with suspected hyperkalemia. Knowledge of the physiological mechanisms of potassium homeostasis is important for understanding the causes and complications of hyperkalemia. Potassium is predominantly an intracellular cation and plays a significant role in the formation of the membrane potential of cell rest. Violation of the transmembrane potassium gradient has a negative effect on the functioning of mainly the cardiovascular and nervous systems. ECG changes are important diagnostic criteria for suspected hyperkalemia. Therefore, in the review, with particular attention, electrophysiological and electrocardiographic changes with an increase in potassium levels, presented by an ECG from our own experience, are discussed. Clinical signs of elevated potassium levels are nonspecific and are predominantly associated with muscle or cardiac dysfunction. Despite various recommendations, there is no generally accepted consensus on the algorithm for the management of patients with hyperkalemia and precise thresholds for potassium concentration. Urgent correction of hyperkalemia is indicated in the presence of ECG changes, severe acidosis, a rapid increase in serum potassium levels and a decrease in renal function. The paper provides an overview of modern views and recommendations for the diagnosis and treatment of hyperkalemia, as well as highlights a number of topical issues that remain unresolved at the present time.

hyperkalemia, homeostasis, mechanisms of regulation, ECG diagnostics, emergency care, treatment.

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«Bulletin of problems biology and medicine» Issue 4 (162), 2021 year, 47-54 pages, index UDK 616.12-008.1-071

10.29254/2077-4214-2021-4-162-47-54