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首页> 外文期刊>Clinical kidney journal. >Pretreatment of enteral nutrition with sodium polystyrene sulfonate: effective, but beware the high prevalence of electrolyte derangements in clinical practice
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Pretreatment of enteral nutrition with sodium polystyrene sulfonate: effective, but beware the high prevalence of electrolyte derangements in clinical practice

机译：用聚苯乙烯磺酸钠预处理肠内营养：有效，但要注意临床实践中电解质紊乱的发生率很高

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Background Current treatment options for chronic hyperkalemia in children with chronic kidney disease include dietary restrictions or enteral sodium polystyrene sulfonate (SPS); however, dietary restrictions may compromise adequate nutrition and enteral SPS may be limited by palatability, adverse effects and feeding tube obstruction. A potentially safer alternative is to pretreat enteral nutrition (EN) with SPS prior to consumption. The purpose of this study was to evaluate the efficacy and safety of pretreating EN with SPS in pediatric patients with hyperkalemia. Methods We performed a retrospective cohort study between September 2012 and May 2016 at the Children’s Hospital of Philadelphia. In all, 14 patients (age range 0.5–53.2 months) who received 19 courses of SPS pretreatment of EN were evaluated. Serum electrolytes were evaluated at baseline and within 1 week of initiating therapy. The primary endpoint was mean change in potassium at 7 days. Secondary endpoints included the mean change in serum sodium, chloride, bicarbonate, calcium, phosphorous and magnesium, as well as the percentage of patients who developed electrolyte abnormalities within the first week of treatment. Results Serum potassium levels decreased from 6.0 to 4.4 mmol/L (P?
机译：背景技术当前对于患有慢性肾脏疾病的儿童的慢性高钾血症的治疗选择包括饮食限制或肠内聚苯乙烯磺酸钠（SPS）。但是，饮食限制可能会损害充足的营养，肠内SPS可能会受到适口性，不良反应和饲管阻塞的限制。可能更安全的替代方法是在食用前用SPS预处理肠内营养（EN）。这项研究的目的是评估在高钾血症患儿中用SPS预处理EN的疗效和安全性。方法我们于2012年9月至2016年5月在费城儿童医院进行了一项回顾性队列研究。总共评估了接受EN的19个疗程的SPS预处理的14例患者（年龄范围0.5-53.2个月）。在基线和开始治疗的1周内评估血清电解质。主要终点是7天时的钾平均变化。次要终点包括血清钠，氯化物，碳酸氢盐，钙，磷和镁的平均变化，以及在治疗的第一周内出现电解质异常的患者百分比。结果在开始SPS预处理1周后，血清钾水平从6.0降至4.4 mmol / L（P 0.001），血清钠水平从135.8升高至141.3 mmol / L（P <0.008）。没有发现平均血清钙或镁水平有显着差异。然而，超过一半的疗程至少导致一种电解质异常，其中低钾血症（31.6％），高钠血症（26.3％）和低钙血症（21.1％）最常见。结论SPS预处理EN是治疗小儿慢性高钾血症的有效方法;但是，必须密切监视电解质。

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