- 同
- transtubular potassium gradient, 細管カリウム勾配、尿細管カリウム勾配、経細管カリウム勾配、経尿細管カリウム勾配
[show details]
細管カリウム勾配 : 9 件
尿細管カリウム勾配 : 1 件
経細管カリウム勾配 : 0 件
経尿細管カリウム勾配 : 1 件
- 皮質集合管でのアルドステロン作用の指標
- 皮質集合管における尿細管腔のカリウム濃度の濃度勾配はアルドステロン作用によってもたらされるため、TTKGがアルドステロン作用が強ければ高くなる。
- Transtubular Potassium Gradient (TTKG) = (POsm * UPotassium ) / (PPotassium x UOsm)
判定
- 解釈はUosm>Sosmの時のみ可能! (濃縮尿であること)
- UCSF
- 参考2
- TTKG >10:有効循環血漿量の減少(脱水/HFなど) or K over intake
- TTKG <10:K 排泄障害が存在
- 参考1
- TTKG < 2 :外的喪失
- TTKG > 2 :腎性喪失
計算
参考
- http://intmed.exblog.jp/760245/
- http://generalsurgery.secret.jp/A_GUIDE_FOR_GENERAL_SURGEONS/fluid_%26_electrolytes/entori/2008/3/24_Hyperkalemia.html
- http://www.ne.jp/asahi/akira/imakura/hypokalemia.htm
PrepTutorEJDIC
- 《略》 teetotal; teetotaller; tuberculin-tested
Wikipedia preview
出典(authority):フリー百科事典『ウィキペディア(Wikipedia)』「2013/09/22 00:16:01」(JST)
[Wiki en表示]
The trans-tubular potassium gradient (TTKG) is an index reflecting the conservation of potassium in the cortical collecting ducts (CCD) of the kidneys. It is useful in diagnosing the causes of hyperkalemia or hypokalemia.[1][2] The TTKG estimates the ratio of potassium in the lumen of the CCD to that in the peritubular capillaries.
The following is the formula for calculating the TTKG:
Note that this formula is valid only when Uosm >300 and UNa >25
The validity of this measurement falls on three assumptions:
- (1) Few solutes are reabsorbed in the medullary collecting duct (MCD)
- (2) Potassium is neither secreted nor reabsorbed in the MCD
- (3)The osmolality of the fluid in the terminal CCD is known
Significant reabsorption or secretion of K in the MCD seldom occurs, except in profound K depletion or excess, respectively.
A typical TTKG in a normal person on a normal diet is 8-9. During hyperkalemia or high potassium intake, more potassium should be excreted in the urine and the TTKG should be above 10. Low levels (<7) during hyperkalemia may indicate mineralocorticoid deficiency, especially if accompanied by hyponatremia and high urine Na.
During potassium depletion or hypokalemia, the TTKG should fall to less than 3, indicating appropriately reduced urinary excretion of potassium.
See also[edit source | edit]
- Hyperkalemia
- Hypoaldosteronism
- Aldosterone
References[edit source | edit]
- ^ Ethier JH, Kamel KS, Magner PO, Lemann J, Halperin ML (April 1990). "The transtubular potassium concentration in patients with hypokalemia and hyperkalemia". Am. J. Kidney Dis. 15 (4): 309–15. PMID 2321642.
- ^ Choi MJ, Ziyadeh FN (March 2008). "The utility of the transtubular potassium gradient in the evaluation of hyperkalemia". J. Am. Soc. Nephrol. 19 (3): 424–6. doi:10.1681/ASN.2007091017. PMID 18216310.
UpToDate Contents
全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.
English Journal
- Electrolyte disturbances in acute pyelonephritis.
- Gil-Ruiz MA, Alcaraz AJ, Marañón RJ, Navarro N, Huidobro B, Luque A.SourcePediatric Emergency Department, Gregorio Marañón University General Hospital, Madrid, Spain. maitegilr@gmail.com
- Pediatric nephrology (Berlin, Germany).Pediatr Nephrol.2012 Mar;27(3):429-33. Epub 2011 Oct 8.
- The aim of this study was to determine whether renal unresponsiveness to aldosterone associated with hyperkalemia is present in infants with acute pyelonephritis in the absence of significant urinary tract anomalies and to describe the clinical characteristics of patients presenting an inadequate re
- PMID 21983846
- Urine potassium per hour as a marker for renal potassium losses.
- Phakdeekitcharoen B, Kreepala C, Boongird S.SourceDivision of Nephrology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand. rabpd@mahidol.ac.th
- Journal of the Medical Association of Thailand = Chotmaihet thangphaet.J Med Assoc Thai.2011 Nov;94(11):1337-45.
- BACKGROUND: Hypokalemia, serum potassium (K) < 3.5 mEq/L, is a serious and common clinical problem. The traditional diagnosis of renal potassium losses is 24-hr urine potassium (24U(K)) > or = 20 mEq/day during hypokalemia. Immediate replacement of potassium is often required to prevent compli
- PMID 22256473
Japanese Journal
- 主要な検査と解釈 (特集 小児の輸液ベーシックガイド)
- カリウム濃度異常の鑑別と是正の方法 (今すぐに役立つ輸液ガイドブック) -- (急性期疾患の治療を目的とした輸液)
Related Links
- 2007年3月20日 ... 尿中カリウムが20mEq/L~40mEq/L(97.5mg/dL~156mg/dL)である時、TTKGが3 以下なら腎臓からのカリウム喪失はなく、TTKGが7以上ならアルドステロンによる腎臓 からのカリウム喪失とされる。 尿中カリウム1日量(蓄尿) 蓄尿のほうが ...
- TTKG の意味するところは使い慣れてない人にとっては分かりづらいかもしれない. 上記 の式の ... TTKG が減少することはなんらかの K 排泄障害があることを意味する。 TTKG >10:有効循環血漿量の減少(脱水/HFなど) or K over intake. TTKG <10:K ...
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