关键词: 环硅酸锆钠,高钾血症,血液透析

Abstract: Ｏｂｊｅｃｔｉｖｅ：The Study delves into the clinical efficacy of sodium zirconium cyclosilicate for treatment of chronic hyperkalemia in maintenance hemodialysis (MHD) patients.
Ｍｅｔｈｏｄｏｌｏｇｙ：A prospective, singlecenter, clinical observational study was conducted. MHD patients with predialysis serum potassium>55 mmol／L after the short interdialytic interval were enrolled. Patient education and dietary management were carried out. Sodium zirconium cyclosilicate 5g once daily on nondialysis days, and titrated towards maintaining normokalemia over 4 weeks, in 5 g／d increments to a maximum of 15 g／d. The drug dose remained stable during the observation period (8 weeks). The primary end point was proportion of patients during the therapeutic observation period who maintained predialysis serum potassium of 40~50 mmol／L during at least three of four hemodialysis treatments,the secondary end points were the serum potassium level before dialysis and the difference of serum potassium concentration before and after hemodialysis.
Ｒｅｓｕｌｔｓ：90 (292％) MHD patients were eligible for chronic hyperkalemia. Of the 25 patients (17 males and 8 females) with predialysis potassium≥55 mmol／L were enrolled, with the mean age of 542±128 years old and mean dialysis duration of 117(74,171) months. During the observation period, 68％ of the patients met the primary efficacy end point. The predialysis serum potassium was maintained at 475±036 mmol／L,which was significantly decreased compared with predialysis serum potassium at baseline(614±057 mmol／L).Intradialytic potassium shift values were significantly lower than that at baseline. The maintenance dose of sodium zirconium cyclosilicate was 5 g／d in 11 patients, 10 g／d in 13 patients, and 15 g／d in 1 patient, respectively. 3 patients experienced gastrointestinal reactions during the does titration duration.
Ｃｏｎｃｌｕｓｉｏｎ：Sodium zirconium cyclosilicate effectively reduced predialysis potassium after the short interdialytic interval in MHD patients with chronic hyperkalemia, and reduced the fluctuation of serum potassium preand postdialysis.

Key words: sodium zirconium cyclosilicate, hyperkalemia, hemodialysis