Potassium has important physiological functions in the human body, such as participating in cell generation and metabolism, maintaining osmotic pressure and acid-base balance, and regulating humoral balance. The normal blood potassium concentration is between 3.5 and 5.5 mmol/L. When the blood potassium content is higher than 5.5 mmol/L, it is called hyperkalemia. Under normal circumstances, 80-90% of potassium is excreted by the kidneys. When renal function is impaired, urinary volume decreases, or dialysis is incomplete, hyperkalemia often occurs.
Symptoms of hyperkalemia:
The main clinical manifestations of hyperkalemia are the cardiovascular system and the neuromuscular system. The severity of its symptoms depends on the degree and speed of blood potassium elevation, as well as the presence or absence of disturbances in plasma electrolytes and water metabolism.
Early neuromuscular symptoms often include numbness in the limbs and around the mouth, extreme fatigue, muscle soreness, pale limbs, and cold dampness. Severe cases include numbness in the limbs, soft paralysis, first in the trunk, then in the limbs, and finally affecting the respiratory muscles, resulting in asphyxia. The central nervous system can manifest as irritability or confusion.
Cardiovascular manifestations include slow heart rate, hypoxia, decreased heart sound, and prone to arrhythmia. In severe cases, it can lead to myocardial paralysis, ventricular flutter, and ventricular fibrillation, leading to sudden cardiac arrest.
Others: Most have clinical manifestations of oliguria or uremia; Gastrointestinal symptoms such as nausea, vomiting, diarrhea, etc
When patients with kidney disease develop hyperkalemia, they often have a decrease in urine output. Therefore, in addition to strictly limiting potassium intake in the diet, it is also necessary to limit the intake of liquids and proteins.
The daily liquid volume should be controlled at the urine volume of the day before yesterday plus 500-800ml. It is best to buy a graduated cup at home to facilitate the control of the total amount of drinking water.
When the condition is stable and there is a small amount of urination, the daily limit of protein is 0.5-0.6g/kg, and high-quality protein such as fish, poultry, meat, eggs, and milk should be selected, accounting for more than 60% of the total protein intake.
At the same time, it is necessary to ensure sufficient energy, mainly carbohydrates, to prevent excessive weight loss and accelerated fat decomposition leading to ketoacidosis, which can further exacerbate the symptoms of hyperkalemia.