在用口服尿素治疗期间,与低血症纠正相关的临床因素
Anissa Pelouto1, Sophie Monnerat2,3, Julie Refardt1,2,3
1Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands.
概括
年龄较大,基线较低的和较高的尿素剂量改善了低血症的纠正. 最初的液体限制也有助于增加水平,指导口服尿素治疗低血症.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 内部医学 内部医学
- 内分泌学 在内分泌学.
背景情况:
- 口服尿素越来越多地用于低血治疗.
- 影响口服尿素正率的因素尚不清楚.
- 识别这些因素可以优化低血量管理.
研究的目的:
- 用口服尿素来识别与低血症纠正相关的因素.
- 以指导临床实践,以口服尿素有效管理低血.
主要方法:
- 在两个大学医院进行的回顾性研究.
- 包括用口服尿素治疗的低血症 (血<135 mmol/L) 的住院患者.
- 线性混合效应模型分析了影响校正的因素.
主要成果:
- 分析了140名患者的161次治疗事件.
- 口服尿素在47%的病例中使低血量正常化.
- 年龄较大,基线较低的,较高的累积尿素剂量和初始液体限制与更大的校正有关.
结论:
- 年龄较大,累积尿素剂量较高,基线血含量较低,以及最初的液体限制与口服尿素更快地纠正低血症有关.
- 这些发现可以帮助临床医生实现逐渐的低血症纠正.
- 口服尿素显示过度校正和透性脱髓化率较低.
相关概念视频
Regulation of Water Intake
492
Osmolality refers to the number of solute particles per kilogram of solvent in a solution. Plasma osmolality specifically indicates the total number of solute particles per kilogram of water in blood plasma. This value reflects the body's hydration status and is tightly regulated through mechanisms controlling water intake and output. While water consumption is a conscious decision, the body has intrinsic regulatory systems to maintain fluid balance. Dehydration, a state of water deficit...
492
Antihypertensive Drugs: Potassium-Sparing Diuretics
504
Liddle syndrome is a genetically inherited form of hypertension characterized by the overactivity of epithelial sodium channels in the nephron, the functional unit of the kidney. This heightened activity leads to increased sodium reabsorption and excessive excretion of potassium. To counteract this, potassium-sparing diuretics such as amiloride are used. They function by blocking these sodium channels, thereby reducing the influx of sodium into the epithelial cells and minimizing the loss of...
504
Regulation of Sodium and Potassium
475
The regulation of sodium and potassium ion concentrations in the human body is a complex process governed primarily by hormones such as aldosterone, antidiuretic hormone (ADH), and atrial natriuretic peptide (ANP).
Sodium Regulation
Sodium ions make up approximately 90% of extracellular cations, with a normal blood plasma concentration of 136–148 mEq/L. A decrease in blood volume and pressure triggers the release of renin from granular cells in the juxtaglomerular complex (JGC), primarily...
Sodium Regulation
Sodium ions make up approximately 90% of extracellular cations, with a normal blood plasma concentration of 136–148 mEq/L. A decrease in blood volume and pressure triggers the release of renin from granular cells in the juxtaglomerular complex (JGC), primarily...
475
Antihypertensive Drugs: Action of Diuretics
658
Diuretics are antihypertensive drugs used to treat hypertension resulting from sodium and water retention. Sodium, vital for fluid balance and nerve or muscle function, is regulated by the kidneys through millions of nephrons. Blood enters nephrons via afferent arterioles, which branch into capillaries called glomeruli. These filter blood plasma, allowing water and solutes, like sodium ions, to pass through capillary walls into Bowman's capsule. The filtrate then flows through various...
658
Renal Tubule and Collecting Duct
900
The renal tubule is divided into three parts: the proximal convoluted tubule (PCT), the Loop of Henle (LOH), and the distal convoluted tubule (DCT).
Proximal Convoluted Tubule (PCT):
The PCT is the initial segment of the renal tubule, extending from the Bowman's capsule that encloses the glomerulus. Its convoluted structure and microvilli-lined cells increase the surface area for reabsorption. The PCT reabsorbs glucose, amino acids, sodium, and water from the filtrate, ensuring essential...
Proximal Convoluted Tubule (PCT):
The PCT is the initial segment of the renal tubule, extending from the Bowman's capsule that encloses the glomerulus. Its convoluted structure and microvilli-lined cells increase the surface area for reabsorption. The PCT reabsorbs glucose, amino acids, sodium, and water from the filtrate, ensuring essential...
900
Disorder of Water Balance
344
Water balance disorders are medical conditions that occur when there is a deviation from the body's water volume or osmolarity, disrupting normal homeostasis and leading todehydration, hypotonic hydration, hyperhydration, edema, or water intoxication.
Dehydration
Dehydration occurs when the body loses fluids (particularly water).
Causes:
The major causes of dehydration include excessive sweating, fever, vomiting, diarrhea, and diuresis.
Signs and Symptoms:
Symptoms primarily include intense...
Dehydration
Dehydration occurs when the body loses fluids (particularly water).
Causes:
The major causes of dehydration include excessive sweating, fever, vomiting, diarrhea, and diuresis.
Signs and Symptoms:
Symptoms primarily include intense...
344


