As we all know, the kidney is an important organ of the human body, and one of its main functions is to excrete metabolic waste in the body. If the kidney fails, resulting in the retention and accumulation of many metabolic waste in the body, it will lead to acidosis, high blood potassium, high blood phosphorus and other clinical manifestations in the human body.
Dialysis patients are generally patients with uremia, which refers to the loss of 90% of kidney function in patients. In fact, after a period of dialysis treatment, kidney function will continue to be damaged. At this time, due to insufficient excretion by the kidneys, the potassium ions we ingest can easily cause hyperkalemia.
Below, I will explain in a simple and understandable way how hemodialysis patients can prevent hyperkalemia.
What is hyperkalemia? Before discussing prevention, let's first understand what hyperkalemia is. Hyperkalemia refers to an excess of potassium ions in the extracellular space. We usually divide it into intracellular fluid and extracellular fluid. And what we commonly refer to as hyperkalemia refers to a high concentration of potassium ions in the extracellular fluid. In general, the normal range for a person is 3.5 millimoles per liter to 5.5 millimoles per liter. When it exceeds 5.5 millimoles per liter, it is defined as hyperkalemia.
Mild hyperkalemia generally has no uncomfortable symptoms, and some patients may experience palpitations, nausea, muscle pain, weakness, difficulty breathing, or sensory abnormalities; For severe hyperkalemia, the most common manifestation is various arrhythmias, with arrhythmia being the most common and severe cases leading to cardiac arrest. Some patients may experience numbness in their fingers, weakness in their limbs, tightness in their chest, stiffness in their tongue, difficulty speaking, loss of consciousness, sluggish movements, and drowsiness when experiencing hyperkalemia.
How to prevent hyperkalemia
How to prevent high blood potassium? Firstly, let's understand the causes of hyperkalemia, including inadequate dialysis, oliguria, constipation, and consumption of potassium rich foods. So, dialysis patients need to pay attention to the following three points to prevent hyperkalemia: Firstly, they should avoid consuming foods high in potassium, such as bananas, oranges, durians, and other fruits, as well as some dark colored and yellow vegetables, which may contain a relatively high amount of potassium ions and can easily cause hyperkalemia after ingestion; There are also fried foods, canned foods, pickled foods, and foods that require preservatives for long storage times, so their potassium content is high. In addition, many patients enjoy traditional Chinese medicine prescriptions. Without consulting a nephrologist, taking a large amount of traditional Chinese medicine decoctions can also lead to the occurrence of hyperkalemia.
In daily work, we generally require patients who undergo dialysis twice a week to control their potassium intake within 1300 milligrams per day, and patients who undergo dialysis three times a week to control their potassium intake within 1500 milligrams per day. For patients with oliguria and anuria, strict restrictions are imposed, and for patients with residual kidney function and high urine output, no restrictions are needed.
So some people may ask, how can we reduce the potassium content in food that must be eaten every day and cannot be avoided?
Let me tell you that potassium ions can dissolve in water, and I will teach you a few tips for removing potassium. How to remove potassium from vegetables? Vegetables can be soaked for more than half an hour or boiled in water for 3 minutes before cooking, which can reduce potassium intake by 1/2 to 2/3; Rhizomes should be peeled, cut into thin slices, soaked in water for 1 day, and constantly changed in water to reduce potassium by 1/2 to 2/3. How to remove potassium from fruits? Boil rice with water and discard the water. Eating the fruit pulp can reduce potassium by 1/2. Other potassium removal methods: Ultra low temperature refrigerated foods contain one-third less potassium than fresh foods.
Secondly, it is necessary to ensure sufficient dialysis. For hemodialysis patients, it is best to have dialysis three times a week, so that the interval between dialysis is relatively short and it is not easy to cause hyperkalemia. Regular hemodialysis is the most effective way to treat hyperkalemia during the dialysis process. The amount of potassium cleared during each dialysis process is approximately 70 to 150 millimoles per liter.
If hyperkalemia occurs repeatedly during the patient's dialysis interval, we can also administer hypokalemic dialysate to the patient. In addition, potassium lowering drugs can reduce blood potassium by binding with potassium ions in the intestine and excreting them together. So potassium lowering drugs are also a common medication for hemodialysis patients.
Thirdly, patients with anuria or oliguria also need to strictly control their water intake. In addition, maintain smooth daily bowel movements.