Kalium: Was man über Kalium wissen sollte

Zusammenfassung

Kalium ist das wichtigste intrazelluläre Kation. Das Verhältnis zwischen intra- und extrazellulärer Kaliumkonzentration bestimmt das Ruhemembranpotenzial der Zelle, somit spielt Kalium eine essenzielle Rolle in der zellulären Erregbarkeit. Der Kaliumgradient zwischen Extra- und Intrazellulärraum wird durch die Aktivität der Na⁺/K⁺-ATPase aufrechterhalten. Die Niere nimmt eine zentrale Rolle im Kaliumhaushalt ein, da die renale Kaliumelimination den aktuellen Bedürfnissen angepasst werden kann. Klinische Zeichen von Störungen des Kaliumhaushaltes sind zwar eher unspezifisch, allerdings können sowohl eine Hypo- als auch eine Hyperkaliämie zu vital bedrohlichen Herzrhythmusstörungen führen. Störungen des Kaliumhaushaltes können einerseits durch eine positive oder negative Bilanz, andererseits aber auch durch Verteilungsstörungen zwischen Intra- und Extrazellulärraum bedingt sein. Die Therapie ist abhängig vom Schweregrad der Störung, wobei neben einer spezifischen Therapie auch die Ursache der Störung beseitigt werden muss.

Abstract

Potassium is the major intracellular cation. Potassium homeostasis is maintained by the activity of the Na⁺/K⁺-ATPase and by renal function. It is critical for many cellular functions, including the excitability of nerve and muscle cells. Therefore, changes of potassium balance may lead to life-threatening cardiac arrhythmias. The electrocardiogram is a fast and easy way to determine whether changes in plasma K⁺ levels influence the heart. In all cases of hyper- or hypokalemia renal dysfunction needs to be excluded, as the kidneys account for 90 % of the excretion of K⁺ intake. Disorders of potassium balance demand early recognition, etiologic discrimination and finally assessing the urgency and establishing the appropriate therapy.

Kaliumhaushalt - transtubulärer Kaliumgradient - Hyperkaliämie - Hypokaliämie

potassium balance - transtubular potassium gradient - hyperkalemia - hypokalemia

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