Hipercaliemia

 Nota: Não confundir com Hipercalcemia.
Hipercaliemia
Hipercaliemia
Eletrocardiograma com alterações resultantes de hipercaliemia
Sinónimos Hiperpotassemia
Especialidade Medicina de emergência, nefrologia
Sintomas Nenhuns, palpitações, dores musculares, fraqueza muscular, parestesia[1][2]
Complicações Parada cardíaca[1][3]
Causas Insuficiência renal, hipoaldosteronismo, rabdomiólise, alguns medicamentos[1]
Método de diagnóstico Concentração de potássio no sangue > 5,5 mmol/L, eletrocardiograma[3][4]
Condições semelhantes Pseudohipercaliemia[1][2]
Tratamento Medicação, dieta pobre em potássio, hemodiálise[1]
Medicação Gluconato de cálcio, dextrose com insulina, salbutamol, bicarbonato de sódio[1][3][5]
Frequência ~2% (entre hospitalizados)[2]
Classificação e recursos externos
CID-11 707162903
DiseasesDB 6242
MedlinePlus 001179
eMedicine 766479
MeSH D006947
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Hipercaliemia ou hiperpotassemia é a concentração elevada de potássio (K+) no sangue.[1] Os níveis normais de potássio situam-se entre os 3,5 e 5,0 mmol/L (ou 3,5 e 5,0 mEq/L), definindo-se hipercaliemia como qualquer valor superior a 5,5 mmol/L.[3][4] Geralmente a hipercaliemia não causa sintomas.[1] Em alguns casos graves pode causar palpitações, dores musculares, fraqueza muscular ou parestesia.[1][2] A hipercaliemia pode causar arritmias que podem resultar em parada cardíaca e morte.[1][3]

Entre as causas mais comuns de hipercaliemia estão a insuficiência renal, hipoaldosteronismo e rabdomiólise.[1] Alguns medicamentos podem também elevar os níveis de potássio, entre os quais a espironolactona, anti-inflamatórios não esteroides e inibidores da enzima de conversão da angiotensina.[1] A condição pode ser classificada quanto à gravidade em leve (5,5–5,9 mmol/L), moderada (6,0–6,4 mmol/L) e grave (>6,5 mmol/L).[3] A hipercaliemia pode ser detetada num eletrocardiograma.[3] Deve ser excluída a possibilidade de pseudohipercaliemia causada pela destruição de células durante ou após a colheita de sangue.[1][2]

Em pessoas com alterações no eletrocardiograma, o tratamento inicial consiste na administração de sais como o Gluconato de cálcio ou o cloreto de cálcio.[1][3] Entre outros medicamentos administrados para baixar rapidamente os níveis de potássio estão a insulina com dextrose, salbutamol e bicarbonato de sódio.[1][5] Recomenda-se que seja interrompida a toma de qualquer medicamento que possa agravar a condição e a adoção de uma dieta pobre em potássio.[1] Entre outras medidas para remover o potássio do corpo estão diuréticos como a furosemida e fármacos que se ligam ao potássio como o poliestireno sulfonato e o ciclossilicato de zircónio sódico e hemodiálise.[1] A hemodiálise é o método mais eficaz.[3]

A hipercaliemia é rara em pessoas de outra forma saudáveis.[6] Entre as pessoas hospitalizadas, a frequência varia entre 1% e 2,5%.[2] A condição está associada ao aumento da mortalidade, quer devido à própria hipercaliemia, quer como indicador de outra doença grave, especialmente em pessoas sem doença renal crónica.[7][6] O termo "hipercaliemia" tem origem no grego ὑπέρ, transl. hupér, hiper- + latim científico kalium, 'potássio' + '-emia', do grego αἷμα, transl. haîma, 'sangue'[8][9][10]

Ver também

Referências

  1. a b c d e f g h i j k l m n o p q Lehnhardt, A; Kemper, MJ (março de 2011). «Pathogenesis, diagnosis and management of hyperkalemia.». Pediatric Nephrology (Berlin, Germany). 26 (3): 377–84. PMC 3061004Acessível livremente. PMID 21181208. doi:10.1007/s00467-010-1699-3 
  2. a b c d e f McDonald, TJ; Oram, RA; Vaidya, B (20 de outubro de 2015). «Investigating hyperkalaemia in adults.». BMJ (Clinical Research Ed.). 351: h4762. PMID 26487322. doi:10.1136/bmj.h4762 
  3. a b c d e f g h i Soar, J; Perkins, GD; Abbas, G; Alfonzo, A; Barelli, A; Bierens, JJ; Brugger, H; Deakin, CD; Dunning, J; Georgiou, M; Handley, AJ; Lockey, DJ; Paal, P; Sandroni, C; Thies, KC; Zideman, DA; Nolan, JP (outubro de 2010). «European Resuscitation Council Guidelines for Resuscitation 2010 Section 8. Cardiac arrest in special circumstances: Electrolyte abnormalities, poisoning, drowning, accidental hypothermia, hyperthermia, asthma, anaphylaxis, cardiac surgery, trauma, pregnancy, electrocution.». Resuscitation. 81 (10): 1400–33. PMID 20956045. doi:10.1016/j.resuscitation.2010.08.015 
  4. a b Pathy MJ (2006). «Appendix 1: Conversion of SI Units to Standard Units». Principles and practice of geriatric medicine. 2 4th ed. Chichester [u.a.]: Wiley. p. Appendix. ISBN 9780470090558. doi:10.1002/047009057X.app01 
  5. a b Mahoney, BA; Smith, WA; Lo, DS; Tsoi, K; Tonelli, M; Clase, CM (18 de abril de 2005). «Emergency interventions for hyperkalaemia.». The Cochrane Database of Systematic Reviews (2): CD003235. PMC 6457842Acessível livremente. PMID 15846652. doi:10.1002/14651858.CD003235.pub2 
  6. a b Kovesdy, CP (6 de setembro de 2016). «Updates in hyperkalemia: Outcomes and therapeutic strategies.». Reviews in Endocrine & Metabolic Disorders. 18 (1): 41–47. PMC 5339065Acessível livremente. PMID 27600582. doi:10.1007/s11154-016-9384-x 
  7. Einhorn, Lisa M.; Zhan, Min; Hsu, Van Doren; Walker, Lori D.; Moen, Maureen F.; Seliger, Stephen L.; Weir, Matthew R.; Fink, Jeffrey C. (22 de junho de 2009). «The frequency of hyperkalemia and its significance in chronic kidney disease». Archives of Internal Medicine. 169 (12): 1156–1162. ISSN 1538-3679. PMC 3544306Acessível livremente. PMID 19546417. doi:10.1001/archinternmed.2009.132 
  8. "caliemia", in Dicionário Priberam da Língua Portuguesa, 2008-2013.
  9. Cohen BJ, DePetris A (2013). Medical Terminology: An Illustrated Guide. [S.l.]: Lippincott Williams & Wilkins. p. 326. ISBN 9781451187564. Cópia arquivada em 8 de setembro de 2017 
  10. Herlihy B (2014). The Human Body in Health and Illness. [S.l.]: Elsevier Health Sciences. p. 487. ISBN 9781455756421. Cópia arquivada em 8 de setembro de 2017 

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