avkАрхивъ внутренней медициныThe Russian Archives of Internal Medicine2226-67042411-6564“SINAPS” LLC10.20514/2226-6704-2022-12-1-5-21avk-1370Research ArticleОБЗОРНЫЕ СТАТЬИREVIEW ARTICLESСовременные подходы к ведению больных с гиперкалиемиейModern Approaches to the Management of Patients with Hyperkaliemiahttps://orcid.org/0000-0001-7479-418XРезникЕ. В.ReznikE. V.

Елена Владимировна Резник

Москва

Elena V. Reznik

Moscow

elenaresnik@gmail.comhttps://orcid.org/0000-0002-0721-4031СеливановА. И.SelivanovA. I.

Москва

Moscow

https://orcid.org/0000-0001-5198-6584ЛуценкоА. Р.LutsenkoA. R.

Москва

Moscow

ГаранинаЛ. К.GaraninaL. A.

Москва

Moscow

https://orcid.org/0000-0002-0161-005XГолуховГ. Н.GolukhovG. N.

Москва

Moscow

ФГАОУ ВО РНИМУ им. Н. И. Пирогова Минздрава России; ГБУЗ ГКБ им. В. М. Буянова ДЗМ; ГБУЗ ГКБ № 31 ДЗМРоссияRussian National Research Medical University (RNRMU) n.a. N. I. Pirogov; City Clinical Hospital n.a. V. M. Buyanov of Healthcare Department of Moscow; City Clinical Hospital № 31 of Healthcare Department of MoscowRussian FederationФГАОУ ВО РНИМУ им. Н. И. Пирогова Минздрава России; ГБУЗ ГКБ им. В. М. Буянова ДЗМРоссияRussian National Research Medical University (RNRMU) n.a. N. I. Pirogov; City Clinical Hospital n.a. V. M. Buyanov of Healthcare Department of MoscowRussian FederationФГАОУ ВО РНИМУ им. Н.И. Пирогова Минздрава РоссииРоссияRussian National Research Medical University (RNRMU) n.a. N. I. PirogovRussian FederationГБУЗ ГКБ им. В. М. Буянова ДЗМРоссияCity Clinical Hospital n.a. V. M. Buyanov of Healthcare Department of MoscowRussian FederationФГАОУ ВО РНИМУ им. Н. И. Пирогова Минздрава России; ГБУЗ ГКБ № 31 ДЗМРоссияRussian National Research Medical University (RNRMU) n.a. N. I. Pirogov; City Clinical Hospital № 31 of Healthcare Department of MoscowRussian Federation202231012022121521Copyright © Резник Е.В., Селиванов А.И., Луценко А.Р., Гаранина Л.К., Голухов Г.Н., 20222022Резник Е.В., Селиванов А.И., Луценко А.Р., Гаранина Л.К., Голухов Г.Н.Reznik E.V., Selivanov A.I., Lutsenko A.R., Garanina L.A., Golukhov G.N.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.medarhive.ru/jour/article/view/1370

Гиперкалиемия — наиболее часто встречающееся нарушение электролитного баланса в клинической практике. Гиперкалиемия может быть обусловлена повышенным поступлением калия в организм, выходом его из клеток и нарушением экскреции почками. Данное состояние ассоциировано с высоким риском смерти от аритмий, поэтому даже н езначительное отклонение уровня калия в сыворотке крови от нормы нуждается в немедленной коррекции. Современные подходы к лечению гиперкалиемии включают устранение провоцирующих факторов и применение калийснижающих препаратов. Хотя ингибиторы ренин-ангиотензин-альдостероновой системы являются в настоящее время самыми лучшими препаратами с кардионефропротективным эффектом, их назначение также может приводить к гиперкалиемии, особенно при сердечной недостаточности, хронической болезни почек и сахарном диабете. В статье подробно рассмотрены вопросы физиологии калиевого обмена, возможные провоцирующие факторы гиперкалиемии, современные подходы к профилактике и лечению этого состояния.

Hyperkalemia is the most common electrolyte imbalance in clinical practice. Hyperkalemia can be caused by an increased intake of potassium into the body, the shift of potassium out of cells or an abnormal renal potassium excretion. This condition is associated with a high risk of death from arrhythmias; therefore, even a slight deviation of the serum potassium level from the norm requires immediate correction. Modern approaches to the treatment of hyperkalemia include the elimination of predictors and the potassium-lowering drugs. Although inhibitors of the renin-angiotensin-aldosterone system are currently the best cardionephroprotective drugs, their administration can lead to hyperkalemia too, especially in heart failure, chronic kidney disease and diabetes mellitus. The article discusses in detail the physiology of potassium metabolism, possible predictors, prevention and treatment of hyperkalemia.

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The authors declare that there are no conflicts of interest present.