High sodium test
The high sodium test was carried out by the following principle. A large amount of sodium salt enters the distal convoluted tubule, promotes the exchange of sodium and potassium, and increases the excretion of urinary potassium, and the blood potassium can be reduced. Inappropriate population: those with obvious hypokalemia have been banned. Forbidden before examination: pay attention to normal diet, pay attention to normal work and rest, and prevent endocrine disorders. Requirements for inspection: 1. Pay attention to the urine for 24 hours before the examination and the amount of potassium, sodium and chlorine in the urine for 24 hours on the 3rd and 6th day of the test. 2. Monitor blood pressure once a day. Basic Information Specialist classification: urinary examination classification: urine / kidney function test Applicable gender: whether men and women apply fasting: fasting Tips: Pay attention to the normal diet, pay attention to normal work and rest, and prevent endocrine disorders. Normal value Normal people can change the blood potassium by inhibiting the secretion of aldosterone. In patients with primary aldosteronism, high sodium has no inhibitory effect on aldosterone secretion, which promotes the exchange of sodium and potassium in the renal tubules, which further increases the removal of urinary potassium. Thus reduced. Clinical significance This test is suitable for patients with mild disease and excessive secretion of suspected aldosterone with no obvious decrease in serum potassium. Abnormal results There are three clinical symptoms of aldosteronism. 1. Hypertensive patients have high blood pressure, and appear earlier, often appear in about 4 years before the onset of hypokalemia. Generally, it is moderately elevated, and the increase in diastolic blood pressure is more obvious. 2. Neuromuscular dysfunction (1) Neuromuscular weakness and paralysis Generally speaking, the lower the blood potassium, the heavier the myopathy. Tiredness, coldness, tension, diarrhea, sweating, and loss of potassium-diuretic diuretics (such as hydrochlorothiazide, furosemide) can be induced. It is often found that the lower limbs cannot move autonomously when they wake up in the morning. The severity of the attack varies, and the severe one can affect the upper limbs, sometimes involving the respiratory muscles. Cranial nerve innervation muscles are generally unaffected. Bilateral flaccid convulsions at the time of onset. (2) Paroxysmal hand, foot and ankle and muscle spasm were found in about 1/3 of patients, with beam arm compression sign (Trousseau sign) and facial nerve attack sign (Chvostek sign). It can last for days to weeks. Can appear alternately with paroxysmal paralysis. 3. Potassium deficiency nephropathy and pyelonephritis People who need to be examined: high blood pressure, neuromuscular dysfunction, potassium-deficient nephropathy and pyelonephritis, and other patients with suspected aldosterone secretion. Precautions Forbidden before examination: pay attention to normal diet, pay attention to normal work and rest, and prevent endocrine disorders. Requirements for inspection: 1. Pay attention to the urine for 24 hours before the examination and the amount of potassium, sodium and chlorine in the urine for 24 hours on the 3rd and 6th day of the test. 2. Monitor blood pressure once a day. Inspection process [method] 1. High sodium fixed diet (sodium 240mEq/day) for 6 days. 2, 24 hours before eating a fixed diet, urine, potassium, sodium, chlorine as a control, the next morning to check blood potassium, sodium, chlorine as a control. 3. On the 3rd and 6th days of starting the fixed diet, take 24-hour urine check for potassium, sodium and chlorine, and take blood on the 4th and 7th morning to check for potassium, sodium and chlorine. If blood potassium has fallen below 3.5mEq/L on the fourth day, it may be considered whether to terminate the test according to the patient's condition. 4, monitor blood pressure once a day Not suitable for the crowd Inappropriate population: those with obvious hypokalemia have been banned. Adverse reactions and risks No related complications or hazards.
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