【Swear】評論

將尿液鹼化可以則增加尿酸的溶解度，降低尿酸沉積在腎小管，過多的bicarbonate反而容易與鈣及磷結合後沈積，且血液鹼化後對患者臨床頗有危害，因此，鹼化尿液不宜過當。

【Chelsea Chen】評論

NS就有效，bicarb 反而還容易讓 CaP 亂沉澱The role of urinary alkalinization with either acetazolamide and/or sodium bicarbonate is unclear and controversial. In the past, alkalinization to a urine pH of 6.5 to 7 or even higher was recommended to increase uric acid solubility, thereby diminishing the likelihood of uric acid precipitation in the tubules. However, this approach has fallen out of favor for the following reasons:●There are no data demonstrating the efficacy of this approach. In addition, the only available experimental study suggested that hydration with saline alone is as effectiv...

【ㄨㄚˊ我什麼都不會】評論

ProphylaxisHydration and urinary alkalinization●For all patients at high or intermediate risk of TLS, we recommend aggressive fluid hydration (2 to 3 L/m2 daily) to achieve a urine output of at least 80 to 100 mL/m2 per hour (Grade 1A). If there is no evidence of acute obstructive uropathy and/orhypovolemia, a loop diuretic may be used to maintain the urine output, if necessary. (See 'IV hydration' above.)●There is no evidence that urinary alkalinization is of benefit, and there are potential harms, especially when phosphate levels are elevated. We recommend that IV administration of...