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首页> 外文期刊>Journal of nephrology. >Heart rate response to hemodialysis-induced changes in potassium and calcium levels.
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Heart rate response to hemodialysis-induced changes in potassium and calcium levels.

机译:对血液透析诱导的钾和钙水平变化的心率反应。

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BACKGROUND: It is well known that hemodialysis affects cardiovascular functions, mainly because of excess body water removal. Conversely, the role of hemodialysis-induced modifications in body fluid characteristics is not yet well-grounded. In particular, the impact of modifications in plasma electrolytes on the pacemaking rhythm of the sinus node has not yet been evaluated. METHODS: Eight patients on regular hemodialysis treatment were studied along a two-hour diffusive dialysis study session without fluid removal. Biochemical (metabolic and hormonal) as well as hemodynamic parameters were measured during the treatment. A computer model of the sinus node cell electrical activity was used to analyse the experimental data. The measured changes in electrolyte concentrations and pH were imposed as model inputs and the model-computed heart rate changes were validated against the measured ones. After validation, numerical simulation was used to obtain a quantitative evaluation of the comparative weight of calcium and potassium on heart rate changes, by simulating treatments leading to different changes in plasma concentrations of such electrolytes. RESULTS: A significant heart rate increase (11%) was obtained following potassium, calcium and pH changes, with no significant variations in indices of autonomic activity. Simulation results revealed that calcium load and potassium removal both accelerate sinoatrial pacemaker beating. Concurrent changes in these electrolyte concentrations may cause heart rate to increase up to 30% at the end of hemodialysis. Heart rate sensitivity to extracellular potassium changes appears to be strictly dependent upon calcium concentration. CONCLUSIONS: Hemodialysis-induced changes in calcium and potassium concentrations may greatly affect the rhythm of the sinus node pacemaker.
机译:背景:众所周知,血液透析影响心血管功能,主要是因为身体含水量过剩。相反,血液透析诱导的体液特性修饰的作用尚未良好地。特别地,尚未评估鼻窦节点的血管节律上的血浆电解质的修饰的影响。方法:沿着两小时扩散透析研究会议研究了8例常规血液透析治疗的患者,没有流体去除。在治疗过程中测量生化(代谢和激素)以及血流动力学参数。窦节点细胞电气活动的计算机模型用于分析实验数据。电解质浓度和pH的测量变化被施加为模型输入,并且模型计算的心率变化对测量的输入进行了验证。验证后,通过模拟导致这种电解质的等离子体浓度不同的变化,测量数值模拟来获得对心率变化对心率变化的比较重量的定量评价。结果:在钾,钙和pH的变化后获得显着的心率增加(11%),自主主义活动的索引没有显着变化。仿真结果表明,钙载荷和钾去除都加速了Sinoatrial起搏器跳动。这些电解质浓度的并发变化可能导致心率延长血液透析结束时增加高达30%。对细胞外钾变化的心率敏感性似乎严格依赖于钙浓度。结论:血液透析诱导的钙和钾浓度的变化可能极大地影响窦节点起搏器的节奏。

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