{"id":7567,"date":"2022-11-22T13:00:22","date_gmt":"2022-11-22T10:00:22","guid":{"rendered":"https:\/\/urbancare.clinic\/hyperkalemia-in-diabetes-newer-insights-into-mechanism-and-treatment\/"},"modified":"2022-11-22T13:00:22","modified_gmt":"2022-11-22T10:00:22","slug":"iperkaliemia-nel-diabete-nuove-intuizioni-sul-meccanismo-e-sul-trattamento","status":"publish","type":"post","link":"https:\/\/urbancare.clinic\/it\/hyperkalemia-in-diabetes-newer-insights-into-mechanism-and-treatment\/","title":{"rendered":"Iperkaliemia nel diabete: nuove intuizioni sul meccanismo e sul trattamento"},"content":{"rendered":"<div><img decoding=\"async\" src=\"https:\/\/urbancare.clinic\/wp-content\/uploads\/2023\/02\/hyperkalemia-in-diabetes-newer-insights-into-mechanism-and-treatment.jpg\" class=\"ff-og-image-inserted\" style=\"display:none\"><\/div>\n<p><span class=\"highwire-journal-article-marker-start\"><\/span><\/p>\n<p id=\"p-1\">L&#039;iperkaliemia \u00e8 una fastidiosa complicanza del diabete che pu\u00f2 presentarsi nelle prime fasi della malattia renale diabetica. L&#039;iperkaliemia \u00e8 spesso definita come potassio sierico superiore a 5,5 mmol\/L, ma alcuni studi suggeriscono addirittura che il potassio sierico superiore a 5,0 mmol\/L dovrebbe qualificarsi per l&#039;iperkaliemia.<span class=\"xref-bibr\">1<\/span> Non solo ha implicazioni cardiovascolari con predisposizione all&#039;aritmia cardiaca, ma preclude anche l&#039;uso di farmaci noti per prevenire la progressione della malattia renale nel diabete, inclusi ACE\/antagonisti del recettore dell&#039;angiotensina (ARB) e antagonisti del recettore dei mineralcorticoidi. Anche altri farmaci come il trimetoprim, utilizzato per le infezioni del tratto urinario, e l&#039;eparina (soprattutto la forma non frazionata) possono essere associati all&#039;iperkaliemia.<span class=\"xref-bibr\">2<\/span> La prevalenza dell&#039;iperkaliemia nei diabetici con funzionalit\u00e0 renale normale \u00e8 difficile da interpretare poich\u00e9 la creatinina sierica non \u00e8 il marker ideale per valutare la funzionalit\u00e0 renale. In uno studio su 1764 pazienti che hanno frequentato una clinica per diabetici per 12 mesi, 15% di pazienti hanno riferito di avere potassio &gt;5,0 mmol\/L, che \u00e8 chiaramente pi\u00f9 alto rispetto alla popolazione generale.<span class=\"xref-bibr\">1<\/span> Discutiamo qui i meccanismi che possono causare l&#039;iperkaliemia nel diabete, che ha un significato nella gestione di questo disturbo.<\/p>\n<p id=\"p-2\">Perch\u00e9 l&#039;iperkaliemia si verifica nel diabete?<\/p>\n<p id=\"p-3\">(1) Ipoaldosteronismo iporeninemico<\/p>\n<p id=\"p-4\">Classicamente, il diabete \u00e8 noto per essere associato a ipoaldosteronismo iporeninemico, che pu\u00f2 portare a iperkaliemia sproporzionata rispetto all&#039;insufficienza renale.<span class=\"xref-bibr\">3<\/span> Vari meccanismi postulati per l&#039;ipoaldosteronismo iporeninemico nel diabete sono illustrati nell&#039;algoritmo 1.<span class=\"xref-bibr\">4<\/span> (Figura 1)<\/p>\n<div id=\"F1\" class=\"fig pos-float odd\" readability=\"6\">\n<div class=\"fig-caption\" readability=\"7\"><span class=\"fig-label\">Figura 1<\/span> <\/p>\n<p id=\"p-5\" class=\"first-child\">Il meccanismo che pu\u00f2 portare all&#039;ipoaldosteronismo iporeninemico nel diabete.<\/p>\n<\/div>\n<\/div>\n<p id=\"p-6\">(2) Assorbimento di sodio attraverso il tubulo prossimale e le vie elettroneutrali<\/p>\n<p id=\"p-7\">IL \u2026 <\/p>\n<p><span class=\"highwire-journal-article-marker-end\"><\/span><a href=\"http:\/\/pmj.bmj.com\/cgi\/content\/short\/98\/1166\/e45?rss=1\">Fonte quotidiana medica<\/a><\/p>\n<p>","protected":false},"excerpt":{"rendered":"<p>L&#039;iperkaliemia \u00e8 una fastidiosa complicanza del diabete che pu\u00f2 presentarsi nelle prime fasi della malattia renale diabetica. L&#039;iperkaliemia \u00e8 spesso definita come potassio sierico superiore a 5,5 mmol\/L, ma alcuni studi suggeriscono addirittura che il potassio sierico superiore a 5,0 mmol\/L dovrebbe qualificarsi per l&#039;iperkaliemia.<cross-ref type=\"bib\" refid=\"R1\">1<\/cross-ref> Non solo ha implicazioni cardiovascolari con predisposizione all&#039;aritmia cardiaca, ma preclude anche l&#039;uso di farmaci noti per prevenire la progressione della malattia renale nel diabete, inclusi ACE\/antagonisti del recettore dell&#039;angiotensina (ARB) e antagonisti del recettore dei mineralcorticoidi. Anche altri farmaci come il trimetoprim, utilizzato per le infezioni del tratto urinario, e l&#039;eparina (soprattutto la forma non frazionata) possono essere associati all&#039;iperkaliemia.<cross-ref type=\"bib\" refid=\"R2\">2<\/cross-ref> La prevalenza dell&#039;iperkaliemia nei diabetici con funzionalit\u00e0 renale normale \u00e8 difficile da interpretare poich\u00e9 la creatinina sierica non \u00e8 il marker ideale per valutare la funzionalit\u00e0 renale. In uno studio su 1764 pazienti che hanno frequentato una clinica per diabetici per 12 mesi, 15% di pazienti hanno riferito di avere...<\/p>","protected":false},"author":2,"featured_media":7568,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"Default","format":"standard","meta":{"page_builder":"","fifu_image_url":"https:\/\/urbancare.clinic\/wp-content\/uploads\/2023\/02\/hyperkalemia-in-diabetes-newer-insights-into-mechanism-and-treatment.jpg","fifu_image_alt":"","footnotes":""},"categories":[185],"tags":[],"class_list":["post-7567","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-research-medical-articles"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Hyperkalemia in diabetes: newer insights into mechanism and treatment - Urban Care Clinic<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/urbancare.clinic\/it\/iperkaliemia-nel-diabete-nuove-intuizioni-sul-meccanismo-e-sul-trattamento\/\" \/>\n<meta property=\"og:locale\" content=\"it_IT\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Hyperkalemia in diabetes: newer insights into mechanism and treatment - Urban Care Clinic\" \/>\n<meta property=\"og:description\" content=\"Hyperkalemia is a troublesome complication in diabetes which may present in early stages of diabetic kidney disease. Hyperkalemia is often defined as serum potassium more than 5.5 mmol\/L, but some studies even suggest serum potassium above 5.0 mmol\/L should qualify for hyperkalemia.1 Not only does it have cardiovascular implications with predisposition to cardiac arrhythmia but it also precludes the use of drugs known to prevent the progression of renal disease in diabetes including ACE\/angiotensin receptor blocker (ARB) and mineralocorticoid receptor antagonist. Other drugs like trimethoprim, which is used for urinary tract infection, and heparin (especially the unfractioned form) may also be associated with hyperkalemia.2 Prevalence of hyperkalemia in diabetics with normal renal functions is difficult to interpret as serum creatinine is not the ideal marker to assess kidney function. In one study among 1764 patients attending diabetic clinic over 12 months, 15% of patients reported to have...\" \/>\n<meta property=\"og:url\" content=\"https:\/\/urbancare.clinic\/it\/iperkaliemia-nel-diabete-nuove-intuizioni-sul-meccanismo-e-sul-trattamento\/\" \/>\n<meta property=\"og:site_name\" content=\"Urban Care Clinic\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/urbancarezanzibar\" \/>\n<meta property=\"article:published_time\" content=\"2022-11-22T10:00:22+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/urbancare.clinic\/wp-content\/uploads\/2023\/02\/hyperkalemia-in-diabetes-newer-insights-into-mechanism-and-treatment.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"1024\" \/>\n\t<meta property=\"og:image:height\" content=\"1024\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"Urban Care Clinic\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Scritto da\" \/>\n\t<meta name=\"twitter:data1\" content=\"Urban Care Clinic\" \/>\n\t<meta name=\"twitter:label2\" content=\"Tempo di lettura stimato\" \/>\n\t<meta name=\"twitter:data2\" content=\"1 minuto\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/urbancare.clinic\\\/hyperkalemia-in-diabetes-newer-insights-into-mechanism-and-treatment\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/urbancare.clinic\\\/hyperkalemia-in-diabetes-newer-insights-into-mechanism-and-treatment\\\/\"},\"author\":{\"name\":\"Urban Care Clinic\",\"@id\":\"https:\\\/\\\/urbancare.clinic\\\/#\\\/schema\\\/person\\\/a304a61bcf298680ee41e2e9ae193930\"},\"headline\":\"Hyperkalemia in diabetes: newer insights into mechanism and treatment\",\"datePublished\":\"2022-11-22T10:00:22+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/urbancare.clinic\\\/hyperkalemia-in-diabetes-newer-insights-into-mechanism-and-treatment\\\/\"},\"wordCount\":252,\"publisher\":{\"@id\":\"https:\\\/\\\/urbancare.clinic\\\/#organization\"},\"image\":{\"@id\":\"https:\\\/\\\/urbancare.clinic\\\/hyperkalemia-in-diabetes-newer-insights-into-mechanism-and-treatment\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/urbancare.clinic\\\/wp-content\\\/uploads\\\/2023\\\/02\\\/hyperkalemia-in-diabetes-newer-insights-into-mechanism-and-treatment.jpg\",\"articleSection\":[\"Research Articles\"],\"inLanguage\":\"it-IT\"},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/urbancare.clinic\\\/hyperkalemia-in-diabetes-newer-insights-into-mechanism-and-treatment\\\/\",\"url\":\"https:\\\/\\\/urbancare.clinic\\\/hyperkalemia-in-diabetes-newer-insights-into-mechanism-and-treatment\\\/\",\"name\":\"Hyperkalemia in diabetes: newer insights into mechanism and treatment - 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Hyperkalemia is often defined as serum potassium more than 5.5 mmol\/L, but some studies even suggest serum potassium above 5.0 mmol\/L should qualify for hyperkalemia.1 Not only does it have cardiovascular implications with predisposition to cardiac arrhythmia but it also precludes the use of drugs known to prevent the progression of renal disease in diabetes including ACE\/angiotensin receptor blocker (ARB) and mineralocorticoid receptor antagonist. Other drugs like trimethoprim, which is used for urinary tract infection, and heparin (especially the unfractioned form) may also be associated with hyperkalemia.2 Prevalence of hyperkalemia in diabetics with normal renal functions is difficult to interpret as serum creatinine is not the ideal marker to assess kidney function. 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