Diagnosis dan Tatalaksana Kegawatdaruratan Hiperkalemia
DOI:
https://doi.org/10.55175/cdk.v48i8.112Kata Kunci:
elektrolit, hiperkalemia, kaliumAbstrak
Hiperkalemia ialah kadar kalium plasma/ serum yang melebihi batas atas rentang normal, yaitu ≥5,5 mEq/L; dapat bervariasi tergantung cut off laboratorium dan sampel pemeriksaan. Hiperkalemia sering dijumpai di instalasi gawat darurat (IGD). Hiperkalemia berat dapat meningkatkan risiko mortalitas hingga 30%, karena menyebabkan aritmia yang mengancam nyawa, seperti fibrilasi ventrikel dan asistol. Hiperkalemia dapat disebabkan oleh perpindahan K+ intraseluler menuju ekstraselular, ekskresi inadekuat, dan intake K+ berlebih pada pasien gangguan ginjal. Tatalaksana hiperkalemia meliputi upaya menstabilkan miokard dan mencegah/ memperbaiki disritmia, redistribusi/pemindahan K+ menuju intraseluler, serta meningkatkan ekskresi K+.
Hyperkalemia is defined as a serum or plasma potassium level above the upper limits of normal range, usually ≥5,5 mEq/L; may vary depending on each laboratory cut off and sample. Hyperkalemia is the most common electrolyte disorder in emergency department. Severe hyperkalemia may increase the mortality up to 30% due to fatal arrhythmia, such as ventricular fibrillation and asystole. Hyperkalemia might be caused by potassium shift to extracellular compartment, inadequate excretion, and increased potassium intake in patients with decreased renal function. Management of hyperkalemia include myocardial stabilization and preventing/ improving dysrhythmia, redistribution/ shifting potassium back to intracellular compartment, and increasing potassium excretion.
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Referensi
Kasper DL, Hauser S, Jameson JL, Fauci AS, Longo DL, Loscalzo J. Harrison’s principles of internal medicine. 19th ed. New York: McGraw-Hill; 2015.
Lindner G, Burdmann EA, Clase CM, Hemmelgarn BR, Herzog CA, Małyszko J, et al. Acute hyperkalemia in the emergency department: A summary from a kidney disease: Improving global outcomes conference. Eur J Emergency Med. 2020;27(5):329.
Simon LV, Hashmi MF, Farrell MW. Hyperkalemia. In: StatPearls [Internet]. 2020 [cited 2020 Oct 26]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK470284/
Dépret F, Peacock WF, Liu KD, Rafique Z, Rossignol P, Legrand M. Management of hyperkalemia in the acutely ill patient. Ann Intensive Care [Internet]. 2019 Feb 28 [cited 2020 Nov 25];9. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6395464/
Montford JR, Linas S. How dangerous is hyperkalemia? J Am Soc Nephrology. 2017;28(11):3155–65.
Best practices in managing hyperkalemia in chronic kidney disease. National Kidney Foundation [Internet]. 2014. Available from: https://www.kidney.org/sites/default/files/02-10-7259%20Hyperkalemia%20Tool.pdf
Lehnhardt A, Kemper MJ. Pathogenesis, diagnosis and management of hyperkalemia. Pediatr Nephrol. 2011;26(3):377–8
Rossignol P, Legrand M, Kosiborod M, Hollenberg S, Peacock W, Emmett M, et al. Emergency management of severe hyperkalemia: Guideline for best practice and opportunities for the future. Pharmacol Res. 2016;113:585-91.
Elliott MJ, Ronksley PE, Clase CM, Ahmed SB, Hemmelgarn BR. Management of patients with acute hyperkalemia. CMAJ. 2010;182(15):1631–5.
Pitt B, Bakris GL. New potassium binders for the treatment of hyperkalemia: Current data and opportunities for the future. Hypertension. 2015;66(4):731–8.
KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease Clinical Practice Guidelines [Internet]. [cited 2019 Nov 26]. Available from: https://www.guidelinecentral.com/summaries/kdigo-2012-clinical-practice-guideline-for-the-evaluation-and-management-of-chronic-kidneydisease/#section-420
Longo DL, Fauci A, Kasper D, Hauser S, Jameson JL, Loscalzo J. Harrison’s manual of medicine. 19th ed. McGraw-Hill; 2016.
An JN, Lee JP, Jeon HJ, Kim DH, Oh YK, Kim YS, et al. Severe hyperkalemia requiring hospitalization: Predictors of mortality. Critical Care. 2012;16(6):225.
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