PDF(Pubmed)
Abstract：
Hyperkalemia, an elevated blood potassium concentration exceeding 5.0 mEq/L, is associated with adverse outcomes and is frequently observed in hospitalized patients. Drug-induced hyperkalemia accounts for a significant proportion of cases, with heparin, commonly used for venous thrombosis prevention, suspected to contribute, though less recognized than other heparin-related side effects. Both unfractionated heparin (UFH) and low molecular weight heparin (LMWH) have been implicated in inducing hyperkalemia, primarily through the suppression of aldosterone levels and modulation of angiotensin II receptors. This systematic review examines the relationship between heparin, particularly LMWH, and hyperkalemia. Thirteen studies involving 1407 patients were analyzed. Findings indicated a lack of highquality evidence, with no significant increase in potassium levels associated with LMWH use. LMWH did not exhibit a dose-response relationship with hyperkalemia incidence. Additionally, mechanisms underlying the hypothetical LMWHinduced hyperkalemia remained inconclusive. While this suggests that LMWH is unlikely to be a primary cause of hyperkalemia, caution is warranted, especially in patients with elevated baseline potassium levels.
摘要：
高钾血症,血钾浓度超过5.0mEq/L，与不良结局相关，在住院患者中经常观察到。药物引起的高钾血症占病例的很大比例,肝素，常用于预防静脉血栓形成，怀疑有贡献，虽然不如其他肝素相关的副作用。普通肝素（UFH）和低分子量肝素（LMWH）都与诱导高钾血症有关。主要通过抑制醛固酮水平和调节血管紧张素II受体。这篇系统的综述探讨了肝素之间的关系，特别是LMWH,和高钾血症.分析了涉及1407名患者的13项研究。调查结果表明缺乏高质量的证据，与LMWH使用相关的钾水平没有显著增加。LMWH与高钾血症发生率没有剂量反应关系。此外,假设的LMWH诱导的高钾血症的潜在机制仍不确定.虽然这表明LMWH不太可能是高钾血症的主要原因，谨慎是必要的，尤其是基线钾水平升高的患者。
