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Glasnik Instituta za štitastu žlezdu i metabolizam "Zlatibor"
2002, vol. 5, br. 5, str. 51-64
jezik rada: srpski
vrsta rada: neklasifikovan
objavljeno: 02/06/2007
Hipokalemija
Klinički centar Srbije, Klinika za kardiologiju, Beograd

e-adresa: lole@net.yu, lole@net.yu, lole@net.yu, lole@net.yu

Sažetak

Hipokalemija predstavlja jedan od najčešćih elektrolitnih poremećaja sa kojima se srećemo u kliničkoj praksi. Od ukupnog kalijuma u organizmu čoveka, 90% se nalazi u ćelijama. Ovakva preraspodela zavisi od aktivnog transporta kroz ćelijsku membranu posredstvom Na/K pumpe. Normalan nivo serumskog kalijuma kreće se od 3,6 do 5,0 mmol/ L. Hipokalemija se definiše kao smanjenje nivoa serumskog kalijuma ispod 3,6mmol/L. U moguće uzroke hipokalemije ubrajaju se neadekvatan unos kalijuma kao i njegov abnorma- lan gubitak. Sasvim retko hipokalemija je uzrokovana ekstremnim prelazom kalijuma iz eks- tracelularnog prostora u intracelularni. Hipokalemija može biti i naslednog porekla. U grupu naslednih hipokalemija ubrajaju se oboljenja u kojima dolazi do promena u sintezi i aktivnosti mineralokortikoida (glikokortikoid-popravljiv hiperaldosteronisam, kongenitalna adrenalna hiperplazia, povremeni eksces mineralokortikoida), bubrežna oboljenja (Liddleov sindrome, tubularna acidoza Bartter-ov and Gitelmann-ov sindrom) i oboljenja koja karakteriše poremećaj celularnog transfera kalijuma (hipokalemijska periodična paraliza). U preostalim slu- čajevima uzrok hipokalemije predstavlja uzimanje pojedinih vrsta lekova. Pacijenti sa hipokalemijom su obično asimptomatski. U težoj hipokalemiji javlja se zamor, slabost i konstipacija. Kod pacijenata sa miokardnom ishemijom, hroničnom srčanom insuficijencijom, hipertrofijom leve komore, blaga do umerena hipokalemija povećava verovatnoću nastanka poremećaja ritma. Hipokalemija kada nije ostvarena restrikcija unosa soli uslovljava povećanje vrednosti sistolnog i dijastolnog arterijskog krvnog pritiska. Osnovu lečenja hipokalemije predstavlja nadoknada kalijuma. Doza kalijuma, uzetog peroralno, od 20 mmol/dnevno je dovoljna u prevenciji hipokalemije, dok je u lečenju neophodan unos od 40 do 100 mmol/dnevno.

Ključne reči

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