Abstract：
Hyperkalaemia is an electrolyte imbalance that impairs muscle function and myocardial excitability, and can potentially lead to fatal arrhythmias and sudden cardiac death. The prevalence of hyperkalaemia is estimated to be 6%-7% worldwide and 7%-10% in Asia. Hyperkalaemia frequently affects patients with chronic kidney disease, heart failure, and diabetes mellitus, particularly those receiving treatment with renin-angiotensin-aldosterone system (RAAS) inhibitors. Both hyperkalaemia and interruption of RAAS inhibitor therapy are associated with increased risks for cardiovascular events, hospitalisations, and death, highlighting a clinical dilemma in high-risk patients. Conventional potassium-binding resins are widely used for the treatment of hyperkalaemia; however, caveats such as the unpalatable taste and the risk of gastrointestinal side effects limit their chronic use. Recent evidence suggests that, with a rapid onset of action and improved gastrointestinal tolerability, novel oral potassium binders (e.g., patiromer and sodium zirconium cyclosilicate) are alternative treatment options for both acute and chronic hyperkalaemia. To optimise the care for patients with hyperkalaemia in the Asia-Pacific region, a multidisciplinary expert panel was convened to review published literature, share clinical experiences, and ultimately formulate 25 consensus statements, covering three clinical areas: (i) risk factors of hyperkalaemia and risk stratification in susceptible patients; (ii) prevention of hyperkalaemia for at-risk individuals; and (iii) correction of hyperkalaemia for at-risk individuals with cardiorenal disease. These statements were expected to serve as useful guidance in the management of hyperkalaemia for health care providers in the region.
摘要：
高钾血症是一种电解质失衡，损害肌肉功能和心肌兴奋性，并可能导致致命的心律失常和心源性猝死。高钾血症的患病率在全球估计为6%-7%，在亚洲为7%-10%。高钾血症经常影响慢性肾脏病患者，心力衰竭,和糖尿病，特别是那些接受肾素-血管紧张素-醛固酮系统（RAAS）抑制剂治疗的患者。高钾血症和中断RAAS抑制剂治疗与心血管事件风险增加相关。住院治疗,和死亡,突出了高危患者的临床困境。常规的钾结合树脂广泛用于治疗高钾血症；然而，诸如难吃的味道和胃肠道副作用的风险等警告限制了它们的长期使用。最近的证据表明，具有快速起效和改善的胃肠道耐受性，新型口服钾粘合剂(例如，patiromer和环硅酸钠锆）是急性和慢性高钾血症的替代治疗选择。优化亚太地区高钾血症患者的护理，召集了一个多学科专家小组审查已发表的文献，分享临床经验，最终形成25项共识声明，涵盖三个临床领域：（i）易感患者的高钾血症危险因素和危险分层；（ii）预防高危人群的高钾血症；（iii）纠正心肾疾病高危人群的高钾血症。预计这些声明将为该地区的医疗保健提供者管理高钾血症提供有用的指导。
