What is the most serious electrolyte disorder associated with kidney disease?
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A range of factors can compromise the kidneys’ ability to perform their vital work. These include illnesses like diabetes or high blood pressure, inflammation and a range of inherited conditions. Deficiency or excess in key minerals like calcium and phosphorous, electrolyte imbalances like sodium and potassium, dehydration and fluid retention can all have their genesis in the kidneys. Show
At the University of Michigan, patients with these issues are evaluated and treated within the General Nephrology Clinic. Here, an expert team provides diagnostic evaluation and treatment planning to help manage these disorders. Signs and SymptomsChanges in the body’s levels of minerals including potassium, magnesium, calcium and sodium—and the corresponding impact these have on the body’s function, muscle strength and heart rhythm can be associated with disorders of kidney or endocrine glands. Unrelated to diabetes mellitus, Diabetes Insipidus can arise from a deficit in antidiuretic hormone (ADH), or by the kidneys’ inability to react to ADH. This results in the formation of large quantities of dilute urine regardless of fluid intake and development of thirst. Fluid imbalances on both ends of the spectrum may be a manifestation of poor kidney health. Edema, which occurs when the body retains too much fluid, commonly causes swelling and pain in the face, arms, legs, hands and feet. Dehydration, which happens when the body loses more fluids than it consumes, can cause a range of symptoms including thirst, weakness, light headedness, fainting and decreases in urine output or increases in its concentration (darker colored urine). Diagnosis and TreatmentMichigan Medicine’s General Nephrology Clinic offers comprehensive diagnostic testing to identify the issues behind these imbalances. In addition to blood and urine testing to identify mineral and electrolyte deficiencies, diagnostics including controlled water deprivation testing and stimulation tests are offered to better understand the nature of a patient’s water and potassium disturbance. Based on the patient’s diagnosis, an individualized treatment plan is developed which may involve medications, dietary and fluid intake recommendations, and lifestyle modifications. Patient Resources
Appointments and ReferralsThe General Nephrology Clinic is located in the Taubman Center, reception area 3C. Appointments can be made directly by calling 734-647-9342. Physician referrals can be made by calling M-Line at 800-962-3555. Disturbances in many electrolyte concentrations in peritoneal dialysis patients may occur. However, the most common are those related to potassium, magnesium, and sodium(1,2). Hyper- and HypokalemiaHyperkalemia generally results from excessive dietary intake and insufficient dialysis. Hypokalemia is due to poor nutritional intake; excessive losses, either through vomiting or diarrhea or excessive dialysate losses; or from increased cellular uptake(1,2). The most common symptoms include mild or severe weakness and cardiac arrhythmias. Approximately 30% of PD patients require oral or IP potassium supplementation or are encouraged to increase their dietary intake. HypermagnesemiaHypermagnesemia is a common finding in CAPD patients particularly among those ingesting magnesium containing phosphate binders, antacids or laxatives. Hypermagnesemia suppresses PTH levels contributing to adynamic bone disease(3). HypernatremiaHypernatremia can result from high ultrafiltration and the repeated use of hypertonic PDF due to excessive removal of water and retention of sodium due to sieving(2). Breadcrumb
CORE Kidney Acid-Base ElectrolytesSub-navigationConditions Treated
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What are Electrolytes?Electrolytes are particles that carry an electric charge when they are dissolved in blood. The kidneys help to maintain electrolyte concentrations by regulating its concentrations in the body. Any disturbance in this process often leads to an electrolyte imbalance. The different electrolytes are:
Renal Failure is often complicated by elevated potassium, phosphate and magnesium and decreased sodium and calcium. Sodium Sodium plays a major role in the body by maintaining fluid balance. Its major function is in nerve and muscle function. The body obtains sodium from food and drink and loses it in sweat and urine. Kidneys, when functioning normally, maintain a consistent level of sodium by adjusting the amount excreted from the body. When sodium intake and excretion are not in balance, it may lead to either high sodium (Hypernatremia) or low sodium (Hyponatremia). Potassium Potassium is necessary for the normal functioning of cells, nerves and muscles. Potassium is obtained from food and drinks and lost primarily in urine, but also through the digestive tract and in sweat. Imbalances in potassium can lead to high potassium (Hyperkalemia) or low potassium (Hypokalemia). Phosphorus In the body, almost all phosphorus is combined with oxygen to form phosphate. Phosphate is used as a building block for many substances such as DNA, cell membranes, etc. The body obtains phosphate from food and excretes it in urine and sometimes stool. Foods that are phosphate rich are milk, egg yolks, chocolate and soft drinks. Imbalances in phosphate may be too high (Hyperphosphatemia) or too low (Hypophosphatemia). Calcium Calcium has many functions which include – formation of bone and teeth, muscle contraction, normal functioning of enzymes, blood clotting and maintenance of normal heart rhythm. The level of calcium in the blood is maintained by 2 hormones – Parathyroid Hormone (PTH) and Calcitonin. The body moves calcium out of bones into the blood to maintain calcium levels. PTH increases the calcium level in blood whereas calcitonin is responsible for lowering calcium level in the blood. Too much calcium is Hypercalcemia and too little calcium is Hypocalcemia. Magnesium Magnesium is required for the formation of bone and teeth and for normal functioning of nerves and muscles. Too much magnesium is Hypermagnesemia and too low magnesium is hypomagnesemia. Disclaimer: The UCLA Health System cannot guarantee the accuracy of such information. The information is provided without warranty or guarantee of any kind. Please speak to your Physician before making any changes. What electrolytes are affected by kidney failure?The levels of electrolytes such as potassium, sodium, magnesium, phosphorus, and calcium can all be affected and lead to a range of symptoms. Fortunately, if the cause of acute kidney failure is reverse and normal renal function returns, the electrolyte disturbances and related symptoms should improve.
Which electrolyte imbalance is lifeHyperkalemia. Although hyperkalemia is defined as a serum potassium concentration >5 mEq/L, it is moderate (6 to 7 mEq/L) and severe (>7 mEq/L) hyperkalemia that are life-threatening and require immediate therapy. Hyperkalemia is most commonly seen in patients with end-stage renal disease.
What electrolyte imbalances most commonly occur related to acute kidney injury?Acute kidney injury (AKI) is associated with electrolyte and acid-base disturbances such as hyperkalemia, metabolic acidosis, hypocalcemia and hyperphosphatemia.
Which electrolyte imbalance is the most immediate lifeEvaluation for immediate threats to life: The most immediate threat to life from AKI is from acute increase in serum K. Patients should have a serum K measured immediately and frequently. Patients with AKI due to pigment nephropathy are especially prone to hyperkalemia.
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