{"id":5827,"date":"2023-08-25T19:55:02","date_gmt":"2023-08-26T00:55:02","guid":{"rendered":"https:\/\/ami.advancedrenaleducation.com\/wparep\/?post_type=article&p=5827"},"modified":"2025-05-09T11:19:43","modified_gmt":"2025-05-09T16:19:43","slug":"hiperkalemia-sp","status":"publish","type":"article","link":"https:\/\/ami.advancedrenaleducation.com\/wparep\/article\/hiperkalemia-sp\/","title":{"rendered":"Hiperkalemia"},"content":{"rendered":"

Los pacientes sometidos a HD de mantenimiento tienen un alto riesgo de hiperkalemia, generalmente definida como concentraciones s\u00e9ricas de potasio (K +)> 5,0 mmol \/ l, incluso cuando reciben un tratamiento adecuado con HD 3 veces por semana. La prevalencia de EE. UU. Del 8,9 al 9,3% entre los pacientes con ERC y \/ o insuficiencia card\u00edaca 1<\/sup>.<\/p>\n

Causas de hiperkalemia en ERET2\u20137<\/sup><\/strong><\/h4>\n

M\u00faltiples factores son responsables de determinar las concentraciones s\u00e9ricas de K +<\/sup> en pacientes con ESRD, incluida la dieta del paciente individual, la prescripci\u00f3n de di\u00e1lisis, los medicamentos y otras afecciones o comorbilidades. Algunos de los factores se enumeran a continuaci\u00f3n:<\/p>\n

    \n
  • Ayuno prolongasdo<\/li>\n
  • Ingesta excesiva de potasio en la dieta<\/li>\n
  • Catabolismo marcado<\/li>\n
  • Rabdomi\u00f3lisis<\/li>\n
  • Deficiencia de insulina<\/li>\n
  • Deficiencia de mineralocorticoides<\/li>\n
  • Medicamentos<\/li>\n
  • Hiperkalemia inducida por di\u00e1lisis (rara)\n
      \n
    • Alta concentraci\u00f3n de potasio en el dializado<\/li>\n
    • Hem\u00f3lisis<\/li>\n
    • Infusiones accidentales de potasio<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n

      S\u00edntomas:<\/strong><\/h4>\n

      Los s\u00edntomas cl\u00ednicos relacionados con la hiperkalemia son inespec\u00edficos y, con mayor frecuencia, asintom\u00e1ticos. Sin embargo, la hiperkalemia afecta a las c\u00e9lulas card\u00edacas y neuromusculares que son particularmente sensibles a los cambios en la [K] s\u00e9rica. En pacientes con hiperkalemia leve a moderada, los pacientes generalmente se quejan de debilidad muscular, fatiga, parestesias, palpitaciones y arritmias card\u00edacas. Como lo demuestran los cambios caracter\u00edsticos en el electrocardiograma (ECG) que sirven como indicadores de arritmias potencialmente mortales, el primer signo de un aumento de la [K] s\u00e9rica es la oscilaci\u00f3n de la onda T. Los cambios en el ECG pueden progresar r\u00e1pidamente junto con los niveles s\u00e9ricos de [K]. Los cambios en el ECG incluyen ensanchamiento del complejo QRS, desarrollo progresivo de bloqueos de la conducci\u00f3n auriculo-ventricular, ritmo idioventricular lento, un trazado del ECG que parece una onda sinusoidal, fibrilaci\u00f3n ventricular y finalmente asistolia8<\/sup>.<\/p>\n

      Manejo9<\/sup><\/strong><\/h4>\n

      Las estrategias de tratamiento est\u00e1n dise\u00f1adas para intervenir en 3 niveles diferentes:<\/p>\n

        \n
      • \n
          \n
        • Efecto sobre la polarizaci\u00f3n de la membrana celular\n
            \n
          • Calcio: estabilizador de las c\u00e9lulas card\u00edacas<\/li>\n<\/ul>\n<\/li>\n
          • Movimiento de potasio extracelular hacia el compartimento intracelular\n
              \n
            • Insulina<\/li>\n
            • Albuterol<\/li>\n
            • Bicarbonato de sodio (en acidosis)<\/li>\n<\/ul>\n<\/li>\n
            • Eliminaci\u00f3n de potasio del cuerpo\n
                \n
              • Resina ligante de potasio con sorbitol<\/li>\n
              • Hemodi\u00e1lisis:\n
                  \n
                • Elimina de 70 a 150 mEq de potasio<\/li>\n
                • Se utiliza como est\u00e1ndar de oro cuando fallan otros tratamientos.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n
                  <\/div>
                  <\/div>\n

                  References:<\/h4>\n
                    \n
                  1. Mu F, Betts KA, Woolley JM, et al. Prevalence and economic burden of hyperkalemia in the United States Medicare population. Curr Med Res Opin<\/em>. 2020;36(8):1333-1341.<\/li>\n
                  2. Bansal S, Pergola PE. Current Management of Hyperkalemia in Patients on Dialysis. Kidney Int reports<\/em>. 2020;5(6):779-789. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/32518860.<\/li>\n
                  3. Clausen T. Na+-K+ pump regulation and skeletal muscle contractility. Physiol Rev<\/em>. 2003;83(4):1269-1324. Available from: http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/14506306.<\/li>\n
                  4. Allon M, Dansby L, Shanklin N. Glucose modulation of the disposal of an acute potassium load in patients with end-stage renal disease. Am J Med<\/em>. 1993;94(5):475-482. Available from: http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/8498392.<\/li>\n
                  5. Allon M, Takeshian A, Shanklin N. Effect of insulin-plus-glucose infusion with or without epinephrine on fasting hyperkalemia. Kidney Int<\/em>. 1993;43(1):212-217. Available from: http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/8433561.<\/li>\n
                  6. Brady HR, Goldberg H, Lunski C, Uldall PR. Dialysis-induced hyperkalaemia presenting as profound muscle weakness. Int J Artif Organs<\/em>. 1988;11(1):43-44. Available from: http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/3360512.<\/li>\n
                  7. Romagnoni M, Beccari M, Sorgato G. Life-threatening hyperkalaemia during a haemodialysis session: an avoidable risk. Nephrol Dial Transplant<\/em>. 1998;13(10):2480-2481. Available from: http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/9794545.<\/li>\n
                  8. Parham WA, Mehdirad AA, Biermann KM, Fredman CS. Hyperkalemia revisited. Texas Hear Inst J<\/em>. 2006;33(1):40-47.<\/li>\n
                  9. Choi HY, Ha SK. Potassium balances in maintenance hemodialysis. Electrolyte Blood Press<\/em>. 2013;11(1):9-16. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/23946760.Electrolyte Blood Press<\/em>. 2013;11(1):9-16. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/23946760.<\/li>\n<\/ol>\n

                    P\/N 103056-01S Rev A 02\/\/2023<\/p>\n

                    <\/div>\n","protected":false},"featured_media":0,"template":"","format":"standard","meta":{"_acf_changed":false},"categories":[274],"tags":[218],"language":[42],"articles":[272],"class_list":["post-5827","article","type-article","status-publish","format-standard","hentry","category-articulos","tag-intradialytic-sp","language-spanish","articles-hemodialisis","entry","no-media"],"acf":[],"yoast_head":"\nHiperkalemia - Advanced Renal Education Program<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/ami.advancedrenaleducation.com\/wparep\/article\/hiperkalemia-sp\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Hiperkalemia - Advanced Renal Education Program\" \/>\n<meta property=\"og:description\" content=\"Los pacientes sometidos a HD de mantenimiento tienen un alto riesgo de hiperkalemia, generalmente definida como concentraciones s\u00e9ricas de potasio (K +)> 5,0 mmol \/ l, incluso cuando reciben un tratamiento adecuado con HD 3 veces por semana. La prevalencia…\" \/>\n<meta property=\"og:url\" content=\"https:\/\/ami.advancedrenaleducation.com\/wparep\/article\/hiperkalemia-sp\/\" \/>\n<meta property=\"og:site_name\" content=\"Advanced Renal Education Program\" \/>\n<meta property=\"article:modified_time\" content=\"2025-05-09T16:19:43+00:00\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data1\" content=\"3 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/ami.advancedrenaleducation.com\/wparep\/article\/hiperkalemia-sp\/\",\"url\":\"https:\/\/ami.advancedrenaleducation.com\/wparep\/article\/hiperkalemia-sp\/\",\"name\":\"Hiperkalemia - Advanced Renal Education Program\",\"isPartOf\":{\"@id\":\"https:\/\/ami.advancedrenaleducation.com\/wparep\/#website\"},\"datePublished\":\"2023-08-26T00:55:02+00:00\",\"dateModified\":\"2025-05-09T16:19:43+00:00\",\"breadcrumb\":{\"@id\":\"https:\/\/ami.advancedrenaleducation.com\/wparep\/article\/hiperkalemia-sp\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/ami.advancedrenaleducation.com\/wparep\/article\/hiperkalemia-sp\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/ami.advancedrenaleducation.com\/wparep\/article\/hiperkalemia-sp\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\/\/ami.advancedrenaleducation.com\/wparep\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Hiperkalemia\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/ami.advancedrenaleducation.com\/wparep\/#website\",\"url\":\"https:\/\/ami.advancedrenaleducation.com\/wparep\/\",\"name\":\"Advanced Renal Education Program\",\"description\":\"\",\"publisher\":{\"@id\":\"https:\/\/ami.advancedrenaleducation.com\/wparep\/#organization\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\/\/ami.advancedrenaleducation.com\/wparep\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"en-US\"},{\"@type\":\"Organization\",\"@id\":\"https:\/\/ami.advancedrenaleducation.com\/wparep\/#organization\",\"name\":\"Advanced Renal Education Program\",\"url\":\"https:\/\/ami.advancedrenaleducation.com\/wparep\/\",\"logo\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\/\/ami.advancedrenaleducation.com\/wparep\/#\/schema\/logo\/image\/\",\"url\":\"https:\/\/ami.advancedrenaleducation.com\/wparep\/wp-content\/uploads\/2023\/03\/1Asset-1.jpg\",\"contentUrl\":\"https:\/\/ami.advancedrenaleducation.com\/wparep\/wp-content\/uploads\/2023\/03\/1Asset-1.jpg\",\"width\":1965,\"height\":381,\"caption\":\"Advanced Renal Education Program\"},\"image\":{\"@id\":\"https:\/\/ami.advancedrenaleducation.com\/wparep\/#\/schema\/logo\/image\/\"}}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Hiperkalemia - Advanced Renal Education Program","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/ami.advancedrenaleducation.com\/wparep\/article\/hiperkalemia-sp\/","og_locale":"en_US","og_type":"article","og_title":"Hiperkalemia - Advanced Renal Education Program","og_description":"Los pacientes sometidos a HD de mantenimiento tienen un alto riesgo de hiperkalemia, generalmente definida como concentraciones s\u00e9ricas de potasio (K +)> 5,0 mmol \/ l, incluso cuando reciben un tratamiento adecuado con HD 3 veces por semana. La prevalencia…","og_url":"https:\/\/ami.advancedrenaleducation.com\/wparep\/article\/hiperkalemia-sp\/","og_site_name":"Advanced Renal Education Program","article_modified_time":"2025-05-09T16:19:43+00:00","twitter_card":"summary_large_image","twitter_misc":{"Est. reading time":"3 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"https:\/\/ami.advancedrenaleducation.com\/wparep\/article\/hiperkalemia-sp\/","url":"https:\/\/ami.advancedrenaleducation.com\/wparep\/article\/hiperkalemia-sp\/","name":"Hiperkalemia - Advanced Renal Education Program","isPartOf":{"@id":"https:\/\/ami.advancedrenaleducation.com\/wparep\/#website"},"datePublished":"2023-08-26T00:55:02+00:00","dateModified":"2025-05-09T16:19:43+00:00","breadcrumb":{"@id":"https:\/\/ami.advancedrenaleducation.com\/wparep\/article\/hiperkalemia-sp\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/ami.advancedrenaleducation.com\/wparep\/article\/hiperkalemia-sp\/"]}]},{"@type":"BreadcrumbList","@id":"https:\/\/ami.advancedrenaleducation.com\/wparep\/article\/hiperkalemia-sp\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/ami.advancedrenaleducation.com\/wparep\/"},{"@type":"ListItem","position":2,"name":"Hiperkalemia"}]},{"@type":"WebSite","@id":"https:\/\/ami.advancedrenaleducation.com\/wparep\/#website","url":"https:\/\/ami.advancedrenaleducation.com\/wparep\/","name":"Advanced Renal Education Program","description":"","publisher":{"@id":"https:\/\/ami.advancedrenaleducation.com\/wparep\/#organization"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/ami.advancedrenaleducation.com\/wparep\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"en-US"},{"@type":"Organization","@id":"https:\/\/ami.advancedrenaleducation.com\/wparep\/#organization","name":"Advanced Renal Education Program","url":"https:\/\/ami.advancedrenaleducation.com\/wparep\/","logo":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/ami.advancedrenaleducation.com\/wparep\/#\/schema\/logo\/image\/","url":"https:\/\/ami.advancedrenaleducation.com\/wparep\/wp-content\/uploads\/2023\/03\/1Asset-1.jpg","contentUrl":"https:\/\/ami.advancedrenaleducation.com\/wparep\/wp-content\/uploads\/2023\/03\/1Asset-1.jpg","width":1965,"height":381,"caption":"Advanced Renal Education Program"},"image":{"@id":"https:\/\/ami.advancedrenaleducation.com\/wparep\/#\/schema\/logo\/image\/"}}]}},"distributor_meta":false,"distributor_terms":false,"distributor_media":false,"distributor_original_site_name":"Advanced Renal Education Program","distributor_original_site_url":"https:\/\/ami.advancedrenaleducation.com\/wparep","push-errors":false,"_links":{"self":[{"href":"https:\/\/ami.advancedrenaleducation.com\/wparep\/wp-json\/wp\/v2\/article\/5827","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/ami.advancedrenaleducation.com\/wparep\/wp-json\/wp\/v2\/article"}],"about":[{"href":"https:\/\/ami.advancedrenaleducation.com\/wparep\/wp-json\/wp\/v2\/types\/article"}],"wp:attachment":[{"href":"https:\/\/ami.advancedrenaleducation.com\/wparep\/wp-json\/wp\/v2\/media?parent=5827"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/ami.advancedrenaleducation.com\/wparep\/wp-json\/wp\/v2\/categories?post=5827"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/ami.advancedrenaleducation.com\/wparep\/wp-json\/wp\/v2\/tags?post=5827"},{"taxonomy":"language","embeddable":true,"href":"https:\/\/ami.advancedrenaleducation.com\/wparep\/wp-json\/wp\/v2\/language?post=5827"},{"taxonomy":"articles","embeddable":true,"href":"https:\/\/ami.advancedrenaleducation.com\/wparep\/wp-json\/wp\/v2\/articles?post=5827"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}