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:
- Sodium
- Potassium
- Phosphorus
- Calcium
- Magnesium
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).
Hypernatremia:
- Symptoms: typically causes thirst. Severe hypernatremia can cause confusion, muscle twitching, seizures, coma and death.
- Diagnosis: by measuring the sodium level in the blood
- Treatment: fluid replacement
Hyponatremia:
- Symptoms: slowness of movements and confusion initially as the brain is sensitive to changes in sodium level in the blood. As it becomes more severe, muscle twitching and seizures occur and it can eventually lead to a coma.
- Diagnosis: by measuring the sodium level in the blood
- Treatment: restricting fluid intake
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).
Hyperkalemia:
- Symptoms: Mild hyperkalemia causes very few symptoms. Some patients may develop muscle weakness. Severe hyperkalemia can cause abnormal heart rhythms.
- Diagnosis: by measuring the potassium level in the blood. Hyperkalemia can also be detected on an electrocardiogram (EKG).
- Treatment: for mild hyperkalemia, treatment involves reducing consumption of potassium or stopping the drugs that prevent the kidney from excreting potassium. For moderate to severe hyperkalemia, the potassium level must be reduced immediately and the heart should be continuously monitored during treatment. If this does not work, dialysis may be needed to remove the excess potassium.
Hypokalemia:
- Symptoms: Mild hypokalemia causes no symptoms. Severe hypokalemia may cause abnormal heart rhythms, muscle weakness, cramping, twitches and even paralysis.
- Diagnosis: measurement of potassium level in the blood, electrocardiogram (EKG) and sometimes measuring potassium levels in the urine.
- Treatment: Potassium supplements.
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).
Hyperphosphatemia:
- Symptoms: Most people with hyperphosphatemia do not have any symptoms. In those with severe kidney disease, calcium combines with phosphate, lowering the calcium levels in blood leading to a disorder called Hypocalcemia. The calcium and phosphate can cause crystals in various body tissues including the walls of blood vessels. This hardening of blood vessels can cause strokes, heart attacks and poor circulation.
- Diagnosis: Measurement of phosphate levels in the blood
- Treatment: A low phosphate diet and drugs to increase phosphate excretion.
Hypophosphatemia:
- Symptoms: Symptoms only occur when phosphate levels are very low. They consist of muscle weakness, followed by stupor, coma and death.
- Diagnosis: Measurement of phosphate levels in the blood
- Treatment: Increase phosphate intake
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.
Hypercalcemia:
- Symptoms: The earliest symptoms are constipation, nausea, vomiting, abdominal pain and loss of appetite. If it is severe, it often causes muscle weakness, abnormal heart rhythms, and brain dysfunction with confusion, delirium, hallucinations, coma and death. Long term or severe hypercalcemia sometimes results in kidney stones containing calcium.
- Diagnosis: Measurement of calcium levels in the blood
- Treatment: Fluid and medications to increase calcium excretion
Hypocalcemia:
- Symptoms: People with chronically low calcium may develop dry scaly skin, brittle nails and coarse hair. Over time it can affect the brain and cause confusion, memory loss, delirium, depression and hallucinations. Extremely low calcium may cause tingling, muscle aches, spasms of the muscles in the throat (causing difficulty breathing), seizures and abnormal heart rhythms.
- Diagnosis: Measurement of calcium levels in the blood.
- Treatment: Calcium supplements and Vitamin D (helps increase calcium absorption from the digestive tract)
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.
Hypermagnesemia:
- Symptoms: It is uncommon and cause muscle weakness, low blood pressure and impaired breathing.
- Diagnosis: Measurement of magnesium levels in the blood
- Treatment: Calcium gluconate and diuretics. Diuretics increase the kidneys’ excretion of magnesium. If the kidneys are nonfunctioning, dialysis is usually required.
Hypomagnesemia:
- Symptoms: loss of appetite, nausea, vomiting, weakness, personality changes, muscle weakness and tremors. If severe, it can lead to seizures.
- Diagnosis: Measurement of magnesium levels in the blood
- Treatment: Magnesium
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.
