How to restore water-electrolyte metabolism. Water balance in the body: causes of disturbance and methods of restoration. Regulation of water-salt balance by the kidneys and urinary system

Intracellular water (70%) is associated with potassium and phosphate, the main cation and anion. Extracellular water makes up about 30% of the total amount in the body. The main cation in the extracellular fluid is sodium, and the anions are bicarbonates and chlorides. The distribution of sodium, potassium and water is presented in table. 5.

Table 5. Distribution of water, sodium and potassium in the body of a man weighing 70 kg (total amount of water - 42 liters (60%) weight) (after A.W. Wilkinson, 1974)
Index	Extracellular fluid			Intracellular fluid
Index	Plasma	Interstitial	Transcellular	Soft fabrics	Bone
Total amount of water, %	7	17	6	60	10
Volume, l	3	7	2	26	4
Sodium	44% of the total, 39.6 g, or 1723 mEq			9% of the total, 8.1 g, or 352 mEq	47% of the total, 42.3 g, or 1840 mEq
Potassium	2% of the total, 2.6 g, or 67 mEq			98% of the total, 127.4 g, or 3312 mEq

According to A.W. Wilkinson (1974), the volume of plasma is 1/3 of the interstitial fluid. Every day, 1100 liters of water are exchanged between blood and intercellular fluid, 8 liters of fluid are secreted into the intestinal lumen and reabsorbed from it.

Sodium metabolic disorders
The sodium content in the blood is 143 meq/l, in the intercellular space 147, in the cells 35 meq/l. Disturbances in sodium balance can manifest themselves in the form of a decrease (hyponatremia), an excess (hypernatremia), or changes in distribution in various environments of the body with normal or altered total amounts in the body.
The decrease in sodium may be true or relative. True hyponatremia is associated with loss of sodium and water. This is observed with insufficient intake of table salt, profuse sweating, with extensive burns, polyuria (for example, with chronic renal failure), intestinal obstruction and other processes. Relative hyponatremia occurs when excessive administration of aqueous solutions at a rate exceeding the excretion of water by the kidneys.
According to A.W. Wilkinson (1974), the clinical manifestations of sodium deficiency are determined primarily by the rate and then by the magnitude of its loss. A slow loss of 250 mEq of sodium only causes a decrease in performance and appetite. A rapid loss of 250-500 and especially 1500 mEq of sodium (vomiting, diarrhea, gastrointestinal fistula) leads to severe circulatory disorders. A deficiency of sodium, and with it water, reduces the volume of extracellular fluid.
A true excess of sodium is observed when patients are given saline solutions, increased consumption of table salt, delayed excretion of sodium by the kidneys, excess production or prolonged administration of external gluco- and mineralcorticoids.
A relative increase in sodium in blood plasma is observed with dehydration.
True hypernatremia leads to overhydration and the development of edema.
Potassium metabolism disorders
98% of potassium is found in intracellular fluid and only 2% in extracellular fluid. Human blood plasma normally contains 3.8-5.1 mEq/L of potassium.
The daily potassium balance in humans was compiled by A. W. Wilkinson (1974). Changes in potassium concentration below 3.5 and above 7 mEq/L are considered pathological and are designated as hypo- and hyperkalemia.

The kidneys play an important role in regulating the amount of potassium in the body. This process is controlled by aldosterone and partially by glucocorticoids. There is an inverse relationship between blood pH and potassium content in plasma, i.e., during acidosis, potassium ions leave the cells in exchange for hydrogen and sodium ions. Reverse changes are observed with alkalosis. It has been established that when three potassium ions leave the cell, two sodium ions and one hydrogen ion enter the cell. With a loss of 25% potassium and water, cell function is impaired. It is known that under any extreme influences, for example during fasting, potassium leaves the cells into the interstitial space. In addition, a large amount of potassium is released through protein catabolism. Therefore, due to the effects of aldosterone and cortisol, the renal mechanism is activated, and potassium is intensively secreted into the lumen of the distal tubules and excreted in large quantities in the urine.
Hypokalemia is observed with excess production or external administration of aldosterone and glucocorticoids, which cause excessive secretion of potassium in the kidneys. A decrease in potassium was also noted with intravenous administration of solutions and insufficient intake of potassium into the body with food. Since potassium excretion occurs continuously, hypokalemia occurs under these conditions. Potassium loss also occurs in the secretions of the gastrointestinal tract during vomiting or diarrhea.
With potassium deficiency, the function of the nervous system is impaired, which manifests itself in drowsiness, fatigue, and slow, slurred speech. Muscle excitability decreases, gastrointestinal motility deteriorates, systemic blood pressure decreases, and pulse slows. The ECG reveals a slower conduction, a decrease in the voltage of all waves, an increase in the QT interval, and a shift of the ST segment below the isoelectric line. An important compensatory reaction aimed at maintaining the constancy of potassium in the blood plasma and cells is to limit its excretion in the urine.
The main causes of hyperkalemia are protein breakdown during fasting, injury, a decrease in circulating blood volume (dehydration and especially impaired K + secretion in conditions of oligo- and anuria (acute renal failure)), excessive administration of potassium in the form of solutions.
Hyperkalemia is characterized by muscle weakness, hypotension, and bradycardia, which can lead to cardiac arrest. The ECG reveals a tall and sharp T wave, widening of the QRS complex, flattening and disappearance of the P wave.
Magnesium metabolism disorders
Magnesium plays an important role in the activation of many enzymatic processes, in the conduction of excitation along nerve fibers, and in muscle contraction. According to A.W. Wilkinson (1974), an adult weighing 70 kg contains about 2000 mEq of magnesium, while potassium is 3400 mEq, and sodium is 3900 mEq. About 50% of magnesium is found in bones, and the same amount is in the cells of other tissues. In the extracellular fluid it is less than 1%.
In adults, the blood plasma contains 1.7-2.8 mg% magnesium. The bulk of it (about 60%) is in ionized form.
Magnesium, like potassium, is an essential intracellular element. The kidneys and intestines take part in the metabolism of magnesium. Absorption takes place in the intestines, and its constant secretion occurs in the kidneys. There is a very close connection between the metabolism of magnesium, potassium and calcium.
It is believed that bone tissue serves as a source of magnesium, which is easily mobilized in case of its deficiency in soft tissue cells, and the process of mobilizing magnesium from bones occurs faster than replenishing it from the outside. With magnesium deficiency, calcium balance is also disturbed.
Magnesium deficiency is observed during fasting and a decrease in its absorption, when lost through the secretions of the gastrointestinal tract as a result of fistulas, diarrhea, resections, as well as its increased secretion after the introduction of sodium lactate into the body.
Determining the symptoms of magnesium deficiency is very difficult, but it is known that the combination of magnesium, potassium and calcium deficiency is characterized by weakness and apathy.
An increase in magnesium in the body is observed as a result of a violation of its secretion in the kidneys and increased cell breakdown in chronic renal failure, diabetes, and hypothyroidism. An increase in magnesium concentration above 3-8 mEq/L is accompanied by hypotension, drowsiness, respiratory depression, and absence of tendon reflexes.
Water balance disorders
Water balance in the body depends on the intake and removal of water from the body. Water loss, especially under pathological conditions, can fluctuate significantly. Disorders of water metabolism are closely related to electrolyte balance and manifest themselves in dehydration (dehydration) and hydration (increasing the amount of water in the body), the extreme expression of which is edema.

Edema (oedema) characterized by excessive accumulation of fluid in body tissues and serous cavities. It is thus accompanied by hyperhydration of the intercellular spaces with a simultaneous disturbance of the electrolyte balance in the cells and their hyper- or hypohydration (BME, vol. 18, p. 150). Water retention is caused by the accumulation of sodium, the main osmotic cation, in the body.

Basic general mechanisms of edema formation

With edema, as a result of disturbances in water-electrolyte metabolism, a huge amount of fluid can accumulate in the tissues. A number of mechanisms are involved in this process.

Dehydration is a pathological process characterized by a lack of water in the body. There are two types of dehydration (Kerpel - Fronius):

Loss of water without an equivalent amount of cations. This is accompanied by thirst and redistribution of water from cells to the interstitial space
Loss of sodium. Compensation for water and sodium occurs from extracellular fluid. Characteristic is poor circulation without the development of thirst.

With dehydration caused by complete fasting, people lose body weight, diuresis decreases to 600 ml/day, and the specific gravity of urine increases to 1.036. Sodium concentration and red blood cell volume do not change. At the same time, dryness of the oral mucosa and thirst occur, and residual nitrogen builds up in the blood (A. W. Wilkinson, 1974).

A.U. Wilkinson proposes to classify dehydration into water and salt. True "water depletion, primary or simple dehydration" is caused by a lack of water and potassium, as a result of which the volume of intracellular fluid changes; characterized by thirst and oliguria. In this case, the osmotic pressure of the interstitial fluid initially increases, and therefore water moves from the cells to the extracellular space. Due to the development of oliguria, the amount of sodium is maintained at a stable level, and potassium continues to be secreted in the distal tubules and excreted in the urine.

True “salt depletion,” secondary or extracellular dehydration, is primarily due to a lack of sodium and water. In this case, the volume of plasma and interstitial fluid decreases and the hematocrit increases. Therefore, its main manifestation is circulatory disorders.

The most serious losses of sodium occur in surgical practice and are caused by the release of gastrointestinal secretions through extensive wound surfaces. In table Figure 6 shows the amount of electrolytes in plasma and various secretions of the digestive tract.

The main causes of salt dehydration are loss of sodium with secretions sucked from the stomach (for example, in operated patients), vomiting, gastrointestinal fistula, and intestinal obstruction. Loss of sodium can lead to a critical decrease in the volume of extracellular fluid and plasma and circulatory impairment, accompanied by hypotension and a decrease in glomerular filtration.

In case of dehydration caused by both water deficiency and sodium loss, normalization of water and electrolyte balance is achieved by simultaneous administration of sodium and water.

Source: Ovsyannikov V.G. Pathological physiology, typical pathological processes. Tutorial. Ed. Rostov University, 1987. - 192 p.

Description:

Hyponatremia - a decrease in sodium concentration in the blood to 135 mmol/l and below, with hypoosmolar and isosmolar hypohydration, means a true Na deficiency in the body. In the case of hypoosmolar overhydration, it may not mean a general sodium deficiency, although in this case it is often observed. (calcium content in the blood is above 2.63 mmol/l).
- decrease in potassium concentration in the blood below 3.5 mmol/l.
- increase in potassium concentration above 5.5 mmol/l.
- decrease in magnesium level below 0.5 mmol/l.

Symptoms:

The clinical picture includes increased neuromuscular excitability, spastic manifestations in the gastrointestinal tract and coronary vessels.

In case of acute calcium poisoning (hypercalcemia), it can develop, which is manifested by acute pain in the epigastrium, thirst, nausea, uncontrollable vomiting, polyuria leading to and then to oligoanuria, hyperthermia, acute circulatory disorders, until it stops.

The main manifestations of hypokalemia: muscle weakness, which can cause hypoventilation, the development of chronic renal failure, decreased tolerance to carbohydrates, dynamic heart rhythm disturbances (fibrillation is possible). On the ECG, the ST interval decreases, RT lengthens, and the T wave flattens. When potassium decreases to 1.5 mmol/l, atrioventricular block develops, and the amplitude of the U wave increases without QT prolongation. Increased sensitivity to cardiac glycosides.

The main clinical manifestations of hyperkalemia: symptoms of neuromuscular damage (weakness, ascending, quadriplegia), intestinal obstruction.

The danger of hyperkalemia is determined by impaired myocardial function. With hyperkalemia of 5–7 mmol/l, the conduction of impulses in the myocardium accelerates; at 8 mmol/l, life-threatening ones occur. The ECG initially shows a tall peaked T wave, followed by prolongation of the PQ interval, disappearance of the P wave, and atrial arrest. Possible widening of the QRS complex, the occurrence of ventricular fibrillation with the development of ventricular fibrillation.
(over 0.75–1 mmol/l) and hypermagnesium histia are observed with a decrease in its excretion by the kidneys, excessive administration, and the use of antacids, especially against the background of chronic renal failure.

Clinical manifestations: with magnesemia 1.25–2.5 mmol/l, nausea, vomiting, feelings of heat and thirst occur. When the concentration exceeds 3.5 mmol/l, drowsiness, hyporeflexia appear, and the conduction of impulses in the myocardium is disrupted. If the magnesium content exceeds 6 mmol/l - coma, respiratory arrest.

Causes:

The main causes of disturbances in water-electrolyte balance are external losses of fluids and pathological redistribution between the main fluid environments.
The main causes of hypocalcemia are:
- trauma to the parathyroid glands;
- radioactive iodine therapy;
- removal of the parathyroid glands;
- .

The most common cause of hypercalcemia is either primary or secondary.

The main causes of hyponatremia include:
- severe debilitating diseases accompanied by decreased diuresis;
- post-traumatic and postoperative conditions;
- extrarenal sodium loss;
- excessive intake of water in the antidiuretic phase of the post-traumatic or postoperative state;
- uncontrolled use of diuretics.

The causes of hypokalemia are:
- displacement of potassium into cells;
- excess potassium losses over its intake is accompanied by hypopotassium histia;
- a combination of the above factors;
- alkalosis (respiratory, metabolic);
- aldosteronism;
- periodic hypokalemic paralysis;
- use of corticosteroids.

The main causes of hyperkalemia are:
- release of potassium from the cell due to its damage;
- potassium retention in the body, most often due to excess intake of catiton into the patient’s body.

The causes of hypomagnesemia may be:

Drugs for REGULATING WATER-ELECTROLYTE BALANCE. ACID-BASE STATUS AND PARENTERAL NUTRITION

Lecture 29

These drugs are widely used in medical practice, mainly to provide emergency care for dehydration, disturbances in osmotic balance, environmental pH, intoxication, severe circulatory and respiratory disorders, etc.

Disturbances of water-salt balance are of three types: 1) dehydration as a result of loss of water from plasma and intercellular fluid (profuse sweating, fever, etc.); in this case, the osmotic pressure of the plasma increases and water leaves the tissues; 2) loss of salts (prolonged vomiting, diarrhea, etc.); at the same time, the osmotic pressure of the plasma decreases and water passes into the tissues; 3) uniform loss of water and salts (mixed disorders). To correct water-electrolyte balance (WEB), salt solutions are used that contain ions of alkali and alkaline earth metals (sodium, potassium, calcium, chlorine, sodium bicarbonate) in strictly defined proportions. In this case, it is necessary to take into account the degree of dehydration, kidney function, and the body’s needs. Both dehydration (hypohydration) and fluid overload (overhydration) are unfavorable. In the first case, blood thickening, hypotension, slowing of blood flow, cell dysfunction, and waste retention develop; in the second - edema, increased blood pressure, cardiac disorders. Water makes up 60–70% of body weight. It has 3 functions: 1) plastic and transport; 2) universal solvent; 3) a chemical reagent involved in all biochemical processes. Water is found in 3 fractions: in free states, in bound states with colloids, and in the composition of molecules of proteins, fats and carbohydrates. Inside the cells there is about 50% water, in the intercellular space - 15%, in the vessels - 5%. The daily requirement of a healthy person is 2500–2700 ml (40 ml/kg). Of this, 1500 ml is excreted through the kidneys, 1000 ml with sweat and through the lungs, and 100 ml with feces. During fever, up to 3–8 liters of water can be released in sweat. The main electrolytes are sodium, potassium, calcium, chlorine, sodium bicarbonate, magnesium, phosphate anion. Saline solutions are prepared based on the electrolyte composition of the plasma. The most physiological solutions are those whose composition is similar to the salt composition of plasma. They must meet 3 requirements: 1) isotonia (equality of osmotic pressure with plasma); 2) isoionicity (equality of ionic composition with plasma); 3) isohydry (pH equality).

An example of such a solution is Ringer's solution, containing sodium chloride, potassium chloride, calcium chloride and sodium bicarbonate. For better utilization of ions, glucose is usually added. Such solutions are called glucose-salt.

Sodium regulated by the adrenal hormone aldosterone (see lecture 28). Na+ is the main extracellular ion that regulates the osmotic pressure of plasma and extracellular fluid, as well as the excitability of cell membranes and intracellular processes. The daily requirement is 5–6 g of sodium chloride. Sodium is easily lost in urine, sweat during hard work and hyperthermia. This causes dehydration of the body. Sodium retention in the body is accompanied by edema. To restore sodium balance use isotonic sodium chloride solution(0.9%), however, infusion of large quantities of it can change the electrolyte ratio. Since dehydration also causes loss of other electrolytes, it is better to use balanced(saline. In children under 3 years of age, preference is given to an isotonic solution with the addition of the required amounts of other ions, since at this age they are poorly excreted by the kidneys. An isotonic solution in children is usually used together with a 5% (isotonic) glucose solution in a ratio of 1:3 (for water-deficient forms) and 1:1 or 1:2 (for salt-deficient and mixed forms) of dehydration. It is also used for washing wounds, for diluting medications, etc. Hypertonic sodium chloride solution(3–10%) are used for washing purulent wounds and intravenously in small quantities in sodium deficiency.

Potassium found predominantly inside cells. Its content is regulated by aldosterone. K+ regulates membrane functions, participating in the processes of polarization and depolarization. The daily requirement is 4–6 g. The potassium content in gastric and intestinal juices is 2 times higher than in the blood, so it is easily lost through vomiting and diarrhea. Loss also occurs when using diuretics, glucocorticoids, in the postoperative period, with extensive burns, frostbite, etc. Hypokalemia characterized by dysfunction of the central nervous system (drowsiness, confusion, lack of deep reflexes), muscle and cardiac weakness (bradycardia, cardiac dilatation, systolic murmur), difficulty in intestinal motility, flatulence, signs of obstruction. Typical ECG changes: lengthening of P-Q and S-T, increase in P, flattening, lengthening, inversion of T, arrhythmia, etc. Prescribed potassium chloride intravenously (on its own or as part of a “balanced” solution), as well as orally in the form of a 10% solution, since in powders and tablets it irritates the mucous membranes. Contraindicated in cases of impaired renal excretory function. Apply panaigias And asparkam, containing potassium and magnesium aslaraginate, which promote the penetration and fixation of potassium in tissues. Prescribe a diet rich in potassium (baked potatoes, dried fruits). An overdose of potassium causes hyperkalemia, which is accompanied by cyanosis, bradycardia, weakened myocardial contractility, ECG changes (widening of the QRS complex, decreased waves, signs of attroventricular block). Treatment: IV 5% glucose solution, calcium chloride, insulin. Insulin and glucose promote the passage of potassium into cells.

Calcium participates in the formation of bone tissue, blood clotting, capillary permeability, nervous and cardiac activity, regulates the permeability of membranes to sodium and potassium, and the contractility of smooth muscle cells. Calcium metabolism is regulated by vitamin D (absorption in the intestine and reabsorption in the kidneys), parathyroidin and thyrocalcitonin (a content in the blood and bones). Potassium antagonist. With hypocalcemia, tetany (laryngospasm, convulsions), cardiac weakness, and hypotension occur. Lack of calcium in children leads to the development of rickets, in adults - to osteomalacia. With hypercalcemia, calcification (calcification) of blood vessels and renal tubules develops. The effect on the heart of calcium is similar to cardiac glycosides, therefore, when used together, it increases their activity and toxicity. Calcium chloride and calcium gluconate are used. The latter dissociates slowly and therefore has a less pronounced irritant effect. It can be prescribed intramuscularly. Used for bone fractures, osteomalacia, rickets, blood clotting disorders, allergies, pulmonary edema, and overdose of potassium and magnesium drugs.

The content and metabolism of magnesium is regulated by aldosterone. Magnesium MD is associated with the ability to inhibit the release of catecholamines from. sympathetic endings. Therefore, magnesium is a calcium antagonist that stimulates the release of norepinephrine. Magnesium promotes the passage of potassium through membranes and its retention in cells, as well as the release of calcium through the kidneys. With a lack of magnesium, calcium precipitates and can clog the kidney tubules. Magnesium reduces the excitability of the central nervous system, reduces muscle tone (skeletal and smooth), and has anticonvulsant, narcotic and hypotensive effects. When taken orally, it has a laxative effect due to an increase in osmotic pressure in the intestinal lumen as a result of dissociation into ions that are poorly absorbed. For resorptive action they introduce magnesium sulfate IV and IM for hypertensive crisis, eclampsia in pregnancy, convulsions, and hypomagnesemia. Hypomagnesemia can occur with the administration of large quantities of solutions and forced diuresis, with hyperaldosteronism, with long-term use of diuretics. With an overdose of magnesium, a sharp depression of the central nervous system, respiration, and a drop in blood pressure develops. Calcium preparations are used as an antagonist.

Plasma replacement solutions are used for blood loss. Saline solutions have small molecules, so they quickly leave the vascular bed and act for a short time (0.5–2 hours). In this regard, synthetic glucose polymers with large molecules are used. They are retained in the vessels for a long time and restore the volume of circulating blood, which is also facilitated by an increase in the osmotic pressure of the plasma. Glucose polymers (dextrans) with a molecular weight of 10,000 to 60,000 are used. These include polyglucin, rheopolyglucin, etc. They are slowly broken down to form glucose, which is recycled. About 40–60% is excreted unchanged by the kidneys. They do not have antigenic properties, therefore they do not cause anaphylactic reactions. They can be administered in large quantities (up to 2 l). Polyglucin has a molecular weight of about 60,000 and does not penetrate the capillaries and glomeruli. After 3 days, up to 30% of the injected volume remains in the blood. Therefore, blood volume, blood pressure, and blood circulation increase for a long time, and hypoxia is eliminated. Contraindicated in case of skull injuries, concussion (increases intracranial pressure). Reopolyglucin has a mass of 30–40 thousand, so it is eliminated from the body faster. It adsorbs toxins well, reduces blood viscosity, platelet aggregation, improves the rheological properties of blood and microcirculation. Used as a plasma substitute, for poisoning, to improve blood circulation, for hypoxia, for the prevention of thrombosis, etc. Hemodez- polyvinylpyrrolidone, has a dehydrating effect, as it increases the osmotic pressure of the blood, improves microcirculation, adsorbs and removes toxins. 80% of the drug is excreted by the kidneys in 4 hours unchanged, removing toxins, so it is widely used for intoxication. Contraindicated for cerebral hemorrhages, kidney diseases with impaired excretory function, and bronchial asthma.

Potassium is involved in carbohydrate metabolism - in the synthesis of glycogen; in particular, glucose moves into cells only together with potassium. It is also involved in the synthesis of acetylcholine, as well as in the process of depolarization and repolarization of muscle cells.

Disorders of potassium metabolism in the form of hypokalemia or hyperkalemia accompany diseases of the gastrointestinal tract quite often.

Hypokalemia can be a consequence of diseases accompanied by vomiting or diarrhea, as well as when absorption processes in the intestine are impaired. It can occur under the influence of long-term use of glucose, diuretics, cardiac glycosides, adrenolytic drugs and during treatment with insulin. Insufficient or incorrect preoperative preparation or postoperative management of the patient - a potassium-poor diet, infusion of solutions that do not contain potassium - can also lead to a decrease in potassium content in the body.

Potassium deficiency may manifest itself as a feeling of tingling and heaviness in the limbs; patients feel heaviness in the eyelids, muscle weakness and fatigue. They are lethargic, have a passive position in bed, slow intermittent speech; swallowing disorders, transient paralysis and even disorders of consciousness may appear - from drowsiness and stupor to the development of coma. Changes in the cardiovascular system are characterized by tachycardia, arterial hypotension, an increase in heart size, the appearance of systolic murmur and signs of heart failure, as well as a typical pattern of changes on the ECG.

Hypokalemia is accompanied by increased sensitivity to the action of muscle relaxants and prolongation of their action time, slower awakening of the patient after surgery, and atony of the gastrointestinal tract. Under these conditions, hypokalemic (extracellular) metabolic alkalosis may also occur.

Correction of potassium deficiency should be based on an accurate calculation of its deficiency and carried out under the control of potassium content and the dynamics of clinical manifestations.

When correcting hypokalemia, it is necessary to take into account the daily need for it, equal to 50-75 mmol (2-3 g). It should be remembered that different potassium salts contain different amounts. So, 1 g of potassium is contained in 2 g of potassium chloride, 3.3 g of potassium citrate and 6 g of potassium gluconate.

It is recommended to administer potassium preparations in the form of a 0.5% solution, always with glucose and insulin at a rate not exceeding 25 mmol per hour (1 g of potassium or 2 g of potassium chloride). In this case, careful monitoring of the patient’s condition, the dynamics of laboratory parameters, as well as an ECG is necessary to avoid overdose.

At the same time, there are studies and clinical observations showing that in case of severe hypokalemia, parenteral therapy correctly selected in terms of volume and set of drugs can and should include a significantly larger amount of potassium drugs. In some cases, the amount of potassium administered was 10 times higher than the doses recommended above; there was no hyperkalemia. However, we believe that potassium overdose and the danger of unwanted effects are real. Caution when administering large amounts of potassium is necessary, especially if constant laboratory and electrocardiographic monitoring is not possible.

Hyperkalemia may be a consequence of renal failure (impaired excretion of potassium ions from the body), massive transfusion of canned donor blood, especially long storage periods, insufficiency of adrenal function, increased tissue breakdown during injury; it can occur in the postoperative period, with excessively rapid administration of potassium supplements, as well as with acidosis and intravascular hemolysis.

Clinically, hyperkalemia is manifested by a “crawling” sensation, especially in the extremities. In this case, muscle dysfunction occurs, tendon reflexes decrease or disappear, and cardiac dysfunction occurs in the form of bradycardia. Typical ECG changes include an increase and sharpening of the T wave, prolongation of the P-Q interval, the appearance of ventricular arrhythmia, up to cardiac fibrillation.

Treatment for hyperkalemia depends on its severity and cause. In case of severe hyperkalemia, accompanied by severe cardiac dysfunction, repeated intravenous administration of calcium chloride is indicated - 10-40 ml of a 10% solution. For moderate hyperkalemia, intravenous glucose with insulin can be used (10-12 IU of insulin per 1 liter of 5% solution or 500 ml of 10% glucose solution). Glucose promotes the movement of potassium from the extracellular space to the intracellular space. With concomitant renal failure, peritoneal dialysis and hemodialysis are indicated.

Finally, it must be borne in mind that correction of the concomitant acid-base imbalance - alkalosis with hypokalemia and acidosis with hyperkalemia - also helps to eliminate potassium imbalances.

The normal sodium concentration in blood plasma is 125-145 mmol/l, and in erythrocytes - 17-20 mmol/l.

The physiological role of sodium lies in its responsibility for maintaining the osmotic pressure of the extracellular fluid and the redistribution of water between the extracellular and intracellular environment.

Sodium deficiency can develop as a result of its losses through the gastrointestinal tract - with vomiting, diarrhea, intestinal fistulas, with losses through the kidneys with spontaneous polyuria or forced diuresis, as well as with profuse sweating through the skin. Less commonly, this phenomenon may be a consequence of glucocorticoid deficiency or excess production of antidiuretic hormone.

Sodium deficiency causes a redistribution of fluid in the body: the osmotic pressure of the blood plasma decreases and intracellular hyperhydration occurs.

Clinically, hyponatremia is manifested by rapid fatigue, dizziness, nausea, vomiting, decreased blood pressure, convulsions, and disturbances of consciousness. As you can see, these manifestations are nonspecific, and to clarify the nature of electrolyte imbalances and the degree of their severity, it is necessary to determine the sodium content in the blood plasma and erythrocytes. This is also necessary for directed quantitative correction.

In case of true sodium deficiency, sodium chloride solutions should be used, taking into account the magnitude of the deficiency. In the absence of sodium losses, measures are necessary to eliminate the causes that caused the increase in membrane permeability, correction of acidosis, use of glucocorticoid hormones, proteolytic enzyme inhibitors, a mixture of glucose, potassium and novocaine. This mixture improves microcirculation, helps normalize the permeability of cell membranes, prevents the increased transition of sodium ions into cells and thereby normalizes sodium balance.

Hypernatremia occurs against the background of oliguria, restriction of fluid intake, with excessive sodium administration, during treatment with glucocorticoid hormones and ACTH, as well as with primary hyperaldosteronism and Cushing's syndrome. It is accompanied by an imbalance of water balance - extracellular hyperhydration, manifested by thirst, hyperthermia, arterial hypertension, and tachycardia. Edema, increased intracranial pressure, and heart failure may develop.

Hypernatremia is eliminated by prescribing aldosterone inhibitors (veroshpiron), limiting sodium intake and normalizing water metabolism.

Calcium plays an important role in the normal functioning of the body. It increases the tone of the sympathetic nervous system, compacts tissue membranes, reduces their permeability, and increases blood clotting. Calcium has a desensitizing and anti-inflammatory effect, activates the macrophage system and phagocytic activity of leukocytes. The normal calcium content in blood plasma is 2.25-2.75 mmol/l.

In many diseases of the gastrointestinal tract, calcium metabolism disorders develop, resulting in either an excess or deficiency of calcium in the blood plasma. Thus, in acute cholecystitis, acute pancreatitis, pyloroduodenal stenosis, hypocalcemia occurs due to vomiting, calcium fixation in areas of steatonecrosis, and increased glucagon content. Hypocalcemia may occur after massive blood transfusion therapy due to the binding of calcium to citrate; in this case, it can also be of a relative nature due to the entry into the body of significant amounts of potassium contained in the preserved blood. A decrease in calcium levels can be observed in the postoperative period due to the development of functional hypocortisolism, which causes the loss of calcium from the blood plasma into bone depots.

Therapy for hypocalcemic conditions and their prevention involve intravenous administration of calcium chloride or gluconate. The prophylactic dose of calcium chloride is 5-10 ml of a 10% solution, the therapeutic dose can be increased to 40 ml. It is preferable to carry out therapy with weak solutions - no higher than 1 percent concentration. Otherwise, a sharp increase in calcium levels in the blood plasma causes the release of calcitonin by the thyroid gland, which stimulates its transition to bone depots; in this case, the concentration of calcium in the blood plasma may fall below the initial level.

Hypercalcemia in diseases of the gastrointestinal tract is much less common, but it can occur in peptic ulcers, stomach cancer and other diseases accompanied by depletion of the function of the adrenal cortex. Hypercalcemia is manifested by muscle weakness and general lethargy of the patient; Nausea and vomiting are possible. When significant amounts of calcium penetrate into cells, damage to the brain, heart, kidneys, and pancreas can develop.

The physiological role of magnesium is to activate the functions of a number of enzyme systems - ATPase, alkaline phosphatase, cholinesterase, etc. It is involved in the transmission of nerve impulses, the synthesis of ATP and amino acids. The concentration of magnesium in blood plasma is 0.75-1 mmol/l, and in erythrocytes - 24-28 mmol/l. Magnesium remains fairly stable in the body, and its loss occurs infrequently.

However, hypomagnesemia occurs with prolonged parenteral nutrition and pathological losses through the intestine, as magnesium is absorbed in the small intestine. Therefore, magnesium deficiency can develop after extensive resection of the small intestine, with diarrhea, intestinal fistulas, and intestinal paresis. The same disorder can occur against the background of hypercalcemia and hypernatremia, during treatment with cardiac glycosides, and with diabetic ketoacidosis. Magnesium deficiency is manifested by increased reflex activity, convulsions or muscle weakness, arterial hypotension, and tachycardia. Correction is carried out with solutions containing magnesium sulfate (up to 30 mmol/day).

Hypermagnesemia is less common than hypomagnesemia. Its main causes are renal failure and massive tissue destruction, leading to the release of intracellular magnesium. Hypermagnesemia can develop against the background of adrenal insufficiency. It is manifested by decreased reflexes, hypotension, muscle weakness, disturbances of consciousness, up to the development of deep coma. Hypermagnesemia can be corrected by eliminating its causes, as well as by peritoneal dialysis or hemodialysis.

Electrolyte imbalance

Description:

Hypercalcemia (calcium content in the blood above 2.63 mmol/l).

Symptoms of Electrolyte Disorders:

The clinical picture of hypocalcemia includes increased neuromuscular excitability, tetany, laryngospasm, spastic manifestations in the gastrointestinal tract and coronary vessels.

Causes of Electrolyte imbalance:

The main causes of disturbances in water-electrolyte balance are external losses of fluids and pathological redistribution between the main fluid environments.

The main causes of hypocalcemia are:

Trauma to the parathyroid glands;

Radioactive iodine therapy;

Removal of parathyroid glands;

Severe debilitating diseases accompanied by decreased diuresis;

Post-traumatic and postoperative conditions;

Extrarenal sodium loss;

Excessive intake of water in the antidiuretic phase of the post-traumatic or postoperative state;

Uncontrolled use of diuretics.

Displacement of potassium into cells;

An excess of potassium loss over its intake is accompanied by hypokalium histia;

A combination of the above factors;

The release of potassium from the cell due to its damage;

Potassium retention in the body, most often due to excess intake of catiton into the patient’s body.

Small bowel resection;

Treatment of Electrolyte Disorders:

Where to go:

Medicines, drugs, tablets for the treatment of Electrolyte imbalance:

Salt complexes for oral rehydration.

Orion Pharma (Orion Pharma) Finland

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Solution for continuous ambulatory peritoneal dialysis

Blood electrolytes: functions, elements, tests and norms, electrolyte disorders

Blood electrolytes are special substances that are positively or negatively charged particles that are formed in the body during the breakdown of salts, acids or alkalis. Positively charged particles are called cations, and negatively charged particles are called anions. The main electrolytes include potassium, magnesium, sodium, calcium, phosphorus, chlorine, and iron.

Electrolytes are contained in blood plasma. Most physiological processes cannot occur without them: maintaining homeostasis, general metabolic reactions, bone formation, contraction and relaxation of muscle fibers, neuromuscular transmission, transudation of fluid from vessels to tissues, maintaining plasma osmolarity at a certain level, activation of most enzymes.

The amount and location of anions and cations determines the permeability of cell membranes. With the help of electrolytes, waste substances are removed from the cell to the outside, and nutrients penetrate inside. Transporter proteins carry out their transfer. The sodium-potassium pump ensures uniform distribution of trace elements in plasma and cells. Due to the constant composition of cations and anions in the body, the complete electrolyte system is electrically neutral.

The causes of water and electrolyte imbalance in the body are divided into physiological and pathological. Physiological factors leading to acid-base imbalance: insufficient fluid intake or excessive consumption of salty foods.

Pathological causes of imbalance include:

Dehydration caused by diarrhea or prolonged use of diuretics,
Persistent decrease in the relative density of urine,
Diabetes,
Post-traumatic syndrome and postoperative condition,
Poisoning the body with aspirin.

Blood test for electrolytes

Pathologies for which it is necessary to donate blood for electrolytes:

A blood test for electrolytes is carried out to monitor dynamics during the treatment of diseases of the kidneys, liver, heart and blood vessels. If the patient has nausea, vomiting, edema, arrhythmia, hypertension and clouding of consciousness, it is also necessary to determine the amount of anions and cations in the blood.

Children and the elderly are especially sensitive to disturbances in the electrolyte balance in the blood, which is due to defective compensation mechanisms. They do not tolerate well and have difficulty adapting to the changing conditions of the internal environment of the body.

Blood is donated from the ulnar vein in the morning on an empty stomach. Experts recommend not drinking alcohol or smoking, and giving up strong tea and coffee the day before the test. Physical overexertion before the study is also undesirable.

Methods for conducting a biochemical blood test for electrolytes:

During the chemical transformations occurring in the blood serum, an insoluble precipitate is formed. It is weighed, the formula and composition are determined, and then recalculated into a pure substance.

Only doctors interpret the laboratory results obtained. When the normal content of calcium, potassium and sodium in the blood is disturbed, a water-electrolyte imbalance develops, which is manifested by swelling of the soft tissues, symptoms of dehydration, paresthesia, and convulsive syndrome.

Potassium

Potassium is an electrolyte that ensures that water balance is maintained at an optimal level. This unique element has a stimulating effect on myocardial function and a protective effect on blood vessels.

The main functions of potassium in the body:

Antihypoxic effect,
Removal of toxins,
Increased strength of heart contractions,
Normalization of heart rate,
Maintaining optimal functioning of immunocompetent cells,
Influence on the development of allergies in the body.

This microelement is excreted by the kidneys with urine, the intestines with feces, and the sweat glands with sweat.

A blood test to determine potassium ions is indicated for kidney inflammation, anuria, and arterial hypertension. Normally, the concentration of potassium electrolytes in infants under one year of age is 4.1 - 5.3 mmol/l; in boys and girls - 3.4 - 4.7 mmol/l; in adults - 3.5 - 5.5 mmol/l.

Hyperkalemia (increased potassium levels in the blood) develops when:

Following starvation diets,
Convulsive syndrome,
Hemolysis of red blood cells,
Dehydration,
Acidification of the internal environment of the body,
Adrenal dysfunction,
Excess of foods containing potassium in the diet
Long-term therapy with cytostatics and NSAIDs.

With prolonged increases in potassium levels in the blood, patients may develop stomach ulcers or sudden cardiac arrest. To treat hyperkalemia, you should consult a doctor.

The causes of hypokalemia (low potassium in plasma) are:

Excessive physical activity
Psycho-emotional stress,
Alcoholism,
Excessive consumption of coffee and sweets,
Taking diuretics
Diets,
Massive swelling,
Dyspepsia,
Hypoglycemia,
Cystic fibrosis,
Hyperhidrosis.

Potassium deficiency in the blood can manifest itself as fatigue, weakness, leg cramps, hyporeflexia, shortness of breath, and cardialgia.

Hypokalemia caused by a lack of intake of the element into the body can be corrected with the help of diet. Topping the list of foods rich in potassium is sweet potatoes. It is baked, fried, boiled, grilled. Fresh tomatoes and tomato paste, beet tops, white beans, lentils, peas, natural yogurt, edible shellfish, dried fruits, carrot juice, molasses, halibut and tuna, pumpkin, bananas, milk are the best sources of potassium.

Sodium

Sodium is the main extracellular cation, an element that helps the body actively grow and develop. It ensures the transport of nutrients to the cells of the body, participates in the generation of nerve impulses, has an antispasmodic effect, activates digestive enzymes and regulates metabolic processes.

The norm of sodium in the blood for adults is 150 mmol/l. (For children – 145 mmol/l).

Sodium leaves the body through sweating. People constantly need it, especially those who experience severe physical activity. You need to constantly replenish your sodium supply. The daily sodium intake is about 550 mg. Plant and animal sources of sodium: table salt, cereals, soy sauce, vegetables, beans, organ meats, seafood, milk, eggs, pickles, sauerkraut.

When the amount of sodium cations in the blood changes, the functioning of the kidneys, nervous system, and blood circulation is disrupted.

A blood test for sodium electrolytes is carried out for gastrointestinal dysfunction, diseases of the excretory system, and endocrine pathologies.

Hypernatremia (increased levels of the element in the blood) develops when:

Excess salt in the diet,
Long-term hormone therapy
Pituitary hyperplasia,
Adrenal tumors,
Comatose state
Endocrinopathies.

The causes of hyponatremia are:

Refusal of salty foods,
Dehydration resulting from repeated vomiting or prolonged diarrhea
Hyperthermia,
Loading doses of diuretics,
Hyperglycemia,
Hyperhidrosis,
Prolonged shortness of breath
Hypothyroidism,
nephrotic syndrome,
Heart and kidney diseases,
Polyuria,
Cirrhosis of the liver.

Hyponatremia is manifested by nausea, vomiting, decreased appetite, palpitations, hypotension, and mental disorders.

Chlorine is a blood electrolyte, the main anion that normalizes water-salt metabolism “paired” with positively charged cations of sodium and other elements (including potassium). It helps to equalize blood pressure, reduce tissue swelling, activate the digestion process, and improve the functioning of hepatocytes.

The level of chlorine in the blood for adults ranges from mmol/l. For children of different ages, the range of normal values is slightly wider (From 95 mmol/l for most age groups and dommol/l. The most chlorine can be contained in the blood of newborns).

An increase in chlorine levels (hyperchloremia) develops when:

Dehydration,
Alkalose,
Kidney pathologies,
Excessive functioning of the glandular cells of the adrenal glands,
Vasopressin deficiency in the body.

The causes of hypochloremia are:

Vomit,
Hyperhidrosis,
Treatment with large doses of diuretics,
Acidotic coma,
Regular intake of laxatives.

Patients with hypochloremia experience hair and teeth loss.

Table salt, olives, meat, dairy and bakery products are rich in chlorine.

Calcium

Calcium is an electrolyte responsible for the normal functioning of the coagulation and cardiovascular systems, regulation of metabolism, strengthening the nervous system, building and ensuring the strength of bone tissue, and maintaining a stable heart rhythm.

The normal level of calcium in the blood is 2-2.8 mmol/l. Its content does not depend on age and gender characteristics. Determination of calcium in the blood must be carried out in case of rarefaction of bone tissue, bone pain, myalgia, diseases of the gastrointestinal tract, heart, blood vessels, and oncopathology.

Hypercalcemia develops when:

Hyperfunction of the parathyroid glands,
Cancerous destruction of bones,
Thyrotoxicosis,
Tuberculous inflammation of the spine,
Kidney pathologies,
Gout,
Hyperinsulinemia,
Excessive intake of vitamin D into the body.

The causes of hypocalcemia are:

Bone formation disorders in children,
Bone loss,
Lack of thyroid hormones in the blood,
Inflammatory and degenerative processes in the pancreas,
Magnesium deficiency
Violation of the bile excretion process,
Liver and kidney dysfunction,
Long-term use of cytostatics and antiepileptic drugs,
Cachexia.

The following foods are sources of calcium: milk, white beans, canned tuna, sardines, dried figs, cabbage, almonds, oranges, sesame seeds, seaweed. Sorrel, chocolate, spinach are foods with an antagonistic effect that suppress the effect of calcium. This microelement is absorbed only in the presence of an optimal amount of vitamin D.

Magnesium

Magnesium is a vital electrolyte that works alone or together with other cations: potassium and calcium. It normalizes myocardial contraction and improves brain function. Magnesium prevents the development of calculous cholecystitis and urolithiasis. It is taken to prevent stress and cardiac dysfunction.

distribution of magnesium ions in the body

The generally accepted norm of magnesium in the blood is 0.65-1 mmol/l. Determination of the amount of magnesium cations in the blood is carried out for patients with neurological disorders, kidney diseases, endocrine pathologies, and rhythm disturbances.

Hypermagnesemia develops when:

Insufficient amount of thyroid hormones in the blood,
Pathologies of the kidneys and adrenal glands,
Dehydration,
Long-term and uncontrolled use of magnesium-containing drugs.

The causes of hypomagnesemia are:

Some foods are sources of magnesium - oatmeal, bran bread, pumpkin seeds, nuts, fish, bananas, cocoa, sesame seeds, potatoes. The absorption of magnesium is impaired by the abuse of alcoholic beverages, frequent use of diuretics, and hormonal drugs.

Iron

Iron is an electrolyte that ensures the transfer and delivery of oxygen to cellular elements and tissues. As a result, the blood is saturated with oxygen, the process of cellular respiration and the formation of red blood cells in the bone marrow are normalized.

Iron enters the body from the outside, is absorbed in the intestines and spreads through the bloodstream throughout the body. Sources of iron are: bran bread, shrimp, crab meat, beef liver, cocoa, egg yolk, sesame seed.

Iron in the body of newborns and children up to one year old varies within 7.90 µmol/l, in children from one to 14 years of age - 8.48 µmol/l, in adults - 8.43 µmol/l.

People with iron deficiency develop iron deficiency anemia, the immune defense and general resistance of the body decrease, fatigue increases, and fatigue quickly occurs. The skin becomes pale and dry, muscle tone decreases, the digestion process is disrupted, and appetite disappears. Characteristic changes are also noted in the cardiovascular and bronchopulmonary systems: increased heart rate, difficulty breathing, shortness of breath. In children, the processes of growth and development are disrupted.

Women need iron more than men. This is due to the loss of a certain part of the element during monthly bleeding. During pregnancy, this is especially important, since two organisms need iron at once - the mother and the fetus. Special medications will help future mothers and nursing women prevent iron deficiency in the body - “Hemofer”, “Sorbifer”, “Maltofer Fol”, “Heferol” (all drugs are prescribed by a doctor!)

Iron electrolytes in the blood are increased with:

Hemochromatosis,
Hypo- and aplastic anemia,
B12-, B6- and folate deficiency anemia,
Violation of hemoglobin synthesis,
Inflammation of the glomeruli of the kidneys,
Hematological pathologies,
Lead intoxication.

The causes of blood iron deficiency are:

Iron-deficiency anemia,
Lack of vitamins
Infections,
Oncopathology,
Massive blood loss
Gastrointestinal dysfunctions,
Taking NSAIDs and glucocorticosteroids,
Psycho-emotional stress.

Phosphorus

Phosphorus is a microelement that is necessary for lipid metabolism, enzyme synthesis, and carbohydrate breakdown. With its participation, tooth enamel is formed, bone formation occurs, and nerve impulses are transmitted. When phosphorus deficiency occurs in the body, the metabolism and absorption of glucose is disrupted. In severe cases, a severe delay in mental, physical, and mental development develops.

Phosphorus enters the body with food and is absorbed into the gastrointestinal tract along with calcium.

In newborns, the amount of phosphorus in the blood serum varies between 1.45-2.91 mmol/l, in children older than one year - 1.45-1.78 mmol/l, in adults - 0.87-1.45 mmol/l.

Hyperphosphatemia develops when:

Long-term hormone therapy and chemotherapy,
Treatment with diuretics and antibacterial drugs,
Hyperlipidemia,
Disintegration of neoplasms and metastasis to bones,
Kidney dysfunction,
Hypoparathyroidism,
Diabetic ketoacidosis,
Hyperproduction of growth hormone by the adenohypophysis,
Decreased bone mineral density.

The causes of hypophosphatemia are:

Impaired fat metabolism, steatorrhea,
Inflammation of the glomerular apparatus of the kidneys,
Hypofunction of growth hormone,
Vitamin D deficiency
Hypokalemia,
Poor nutrition
Deposition of urate in joints,
Overdose of insulin, salicylates,
Parathyroid hormone-producing tumors.

All blood electrolytes are necessary for the health of the body. They participate in metabolic processes and are part of the chemical composition of enzymes, vitamins, and proteins. When one microelement changes, the concentration of other substances is disrupted.

For patients with a deficiency of one or another electrolyte, specialists prescribe complex vitamin and mineral preparations. Adequate nutrition is important to prevent a lack of electrolytes in the blood.

Blood electrolytes: what they are, their functions and content levels

Blood plasma consists primarily of water (90%), protein (8%), organic substances (1%) and electrolytes (1%).

Blood electrolytes are special substances that exist in the form of salts, acids or alkalis. When interacting with water, they are able to disintegrate and form small positively and negatively charged particles. Such processes entail a change and maintenance of electrical conductivity inside cells and in the intercellular space.

The main electrolytes in the body include sodium, chlorine, potassium, calcium, and magnesium. These substances enter the body with food and are excreted primarily by the kidneys.

Blood electrolyte testing is necessary to assess a person's health, particularly to monitor normal kidney and heart function.

In this article we will take a closer look at what it is and what importance blood electrolytes have for the body.

What role and functions do electrolytes perform in the blood?

Without electrical balance in the body, normal metabolism, full muscle function, transmission of impulses to nerve endings, contraction of heart cells and many other processes are impossible. Therefore, the functions of electrolytes are very diverse; their main responsibilities can be identified as follows:

ensuring normal acidity in the blood;
enzyme activation;
transportation of water from vessels to tissues;
responsibility for metabolic processes;
participation in mineralization and strengthening of bones.

What the analysis shows

Typically, a laboratory test for the level of electrolytes in the blood is prescribed to the patient if the doctor suspects a metabolic disorder in the body. As a rule, the body experiences a deficiency of electrolyte elements as a result of fluid loss, for example, with prolonged vomiting or diarrhea, with large blood loss, or with severe burns.

The lack of required elements is especially evident in young children and the elderly.

After receiving the result of a blood test for electrolytes, the doctor decides to prescribe to the patient a saline solution of the element that is missing, or, conversely, diuretics to remove excess salts from the body.

In order for the analysis of electrolytes to be as truthful as possible, you need to know the rules and features of preparing for this study.

How to donate blood for electrolytes?

Before you go to donate blood for electrolytes, you need to consult a specialist, and also notify him about the medications you are currently taking, since the results of the study may be greatly distorted. The specialist will advise you on the best course of action in your case.

An electrolyte test is taken strictly on an empty stomach, in the morning. Before undergoing the study, you need to reduce active physical activity. load, and is also in a calm state. In addition, the patient is strongly recommended to stop drinking alcoholic beverages and smoking 24 hours before. Tea, caffeine-containing products and various carcinogenic additives are highly not recommended to be included in the diet of a patient preparing to take a biochemical blood electrolyte test.

The determination of one or another element in blood plasma is carried out using special laboratory equipment using one of the methods: gravimetric or photoelectrocolorimetry.

Normal blood electrolytes

The interpretation of the analysis and electrolytic composition of the blood is carried out exclusively by a specialist in accordance with the standards established for each element separately. There is a table of blood electrolyte norms that the attending physician relies on.

The norm for most electrolytes does not depend on age category and gender; this applies to the following elements:

As for other electrolytes, including iron, phosphorus, potassium, etc., their regulatory boundaries are determined based on the patient’s gender and age.

Read what high potassium in the blood leads to here.

The normal blood test for electrolytes is determined by the doctor individually, depending on the physiological data, as well as the health status of the patient.

Electrolyte imbalance

Elevated electrolytes in the blood can occur for completely different reasons. Depending on which element’s concentration strongly deviates upward from the norm, one can judge the presence of a particular pathology or disorder.

For example, a high level of magnesium in the blood may indicate kidney or adrenal failure, dehydration, or decreased functionality of the parathyroid gland.

Increased sodium (hypernatremia) promises the patient a salt overload in the body and, as a consequence, the development of kidney diseases associated with oliguria (poor urine output).

If hypercalcemia (excess calcium in the blood) is left untreated, you can develop kidney stones.

Excess potassium leads to numbness and weakness of the muscles; in addition, with a strong excess, the heartbeat is greatly disturbed, which often leads to a heart attack.

Often a person exhibits signs of electrolyte deficiency. Often, a lack of certain chemicals in the body leads to a deterioration in the condition of blood vessels and bones, poor health, heart failure, kidney disorders and other pathological processes. Therefore, if you have symptoms of electrolyte imbalance or are suffering from a deficiency of any element, consult your doctor about prescribing a special vitamin and mineral complex. As a “first aid”, you can start drinking special sports drinks fortified with basic essential electrolytes.

Do not allow the level of electrolytes in the blood to greatly exceed or decrease; the body must have an optimal balance of all necessary substances; it is in your interests to monitor this.

Urinalysis (46)
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Prolactin is one of the main female hormones that regulate the functioning of the reproductive system. But its most important function is to provide.

What is prolactin in women? This is a hormonal component whose main task is to stimulate the production of breast milk. Therefore, he contributes.

Prolactin is a hormone produced by pituitary cells. And although this substance is responsible for the process of lactation in women, it is for the full functioning of the male body.

Vitamin D3, calcitonin and parathyroid hormone are three components necessary to normalize calcium metabolism. However, the most powerful is parathyroid hormone, or for short.

Hyperprolactinemia, or excess prolactin in women, is a deviation that in some cases requires immediate intervention. If increasing the level of this.

Cancer of various types today is one of the most severe and bitter diseases of our century. Cancer cells may not produce oxygen for a long time.

Blood is the most important component of a living organism; it is a liquid tissue consisting of plasma and formed elements. By shaped elements we mean.

Poikilocytosis is a condition or disease of the blood in which the shape of red blood cells is modified or deformed to one degree or another. Red blood cells are responsible.

Science has been studying human blood for a long time. Today, in any modern clinic, the results of a blood test can reveal the general condition of the body.

A blood test can provide, if not complete, then a sufficient amount of information about the state of health of the body. Therefore, it is very important to pass it correctly, even a small one.

Looking at the results of a general blood test, any experienced doctor will be able to preliminarily assess the patient’s condition. ESR is an acronym that stands for sedimentation rate.

Electrolyte balance in the human body and its disturbances

Electrolyte balance is the basis for all chemical and biochemical processes. The correct electrolyte balance of a person allows all systems and organs to function perfectly, forming an optimal acid-base balance. Any loss of fluid can disrupt the electrolyte balance of the human body: diarrhea, repeated vomiting, bleeding, increased sweating, extreme physical activity, elevated ambient temperature, etc. In order to restore the electrolyte balance of the blood, it is necessary to balance the content of some microelements with alkaline and acidic reactions and increase the drinking ration. Achieving an ideal balance of electrolytes in the body can only be achieved by optimizing the diet, reducing the amount of table salt consumed and increasing the intake of clean water. In some cases, it is necessary to take additional potassium, since as a result of a violation of its content, all possible problems in the functioning of the heart begin.

Basic electrolytes in the human body: role and exchange

The main electrolytes in the body are trace elements such as sodium, potassium and chlorine. Potassium is the most valuable electrolyte in the human body, as it is vital for the functioning of all living cells. Electrolytes include potassium, sodium and chlorine salts, as well as bicarbonates. They are responsible for the acid-base balance. Too high or too low levels of electrolytes are life-threatening. The body needs sodium and chlorine, as well as potassium, daily.

Alterations in normal potassium levels are often caused by an existing medical condition or medications, rather than by poor diet. Potassium is necessary for the normal functioning of cell membranes, but only together with sodium. Potassium compounds are found inside the cell, while sodium compounds remain outside, on the other side of the membrane. Only then can the cell function normally.

The role of electrolytes in the human body can be assessed by at least this fact: potassium “fights” with sodium for water reserves in the cell. When sodium enters a cell, it brings water with it. And part of the potassium is removed from the cell and excreted in the urine. When potassium is stronger than sodium, it enters through the membrane and throws out some of the sodium and water. If the exchange of electrolytes in the body is not impaired, then the potassium-sodium pump works properly and does not lead to edema or dehydration.

The cell membrane protects a healthy cell. When allergens, toxic substances or dangerous bacteria approach it, it does not let them through. And it actively promotes the transfer of nutrients. But the cell does not always manage to maintain its optimal state.

Another role of electrolytes in the human body is to maintain the concentration of magnesium necessary for heart function. Their content is interconnected: if the level of magnesium decreases, then the level of potassium also decreases.

To a person who is not professionally involved in medicine, maintaining some kind of acid-base balance will not seem very important, and it will not be very clear. Of course, it is clearer when they say that one vitamin strengthens bones, while another improves vision. Someone reads and thinks: I’ll take vitamins, but I won’t have my thoughts occupied with some kind of membranes. But you don’t have to think about it, the doctors will think about it.

Violation of the electrolyte balance of blood in the human body

Maintaining the balance of electrolytes in the human body is the main task of those who strive to prevent cardiovascular diseases and cancer, which occupy the first place among the causes of mortality. According to recent experimental data, electrolyte imbalance in the body is the root cause of many diseases.

The adrenal glands produce the hormone aldosterone, which retains sodium in the body. Under stress, the production of the hormone increases, sodium and water are poorly excreted, remaining in the body. Therefore, under stress, blood pressure increases, resulting in a persistent disturbance of the electrolyte balance of the blood, resistant to pharmacological methods.

At the same time, there is a lot of sodium in the body, and there is a danger of potassium loss. In these cases, in order not to increase the imbalance of electrolytes in the body, you do not need to consume foods rich in sodium: ketchups, canned foods, salted nuts, foods with soda, crackers, chips.

The upcoming surgery is also stressful. There is little potassium in the muscles, so postoperative intestinal paresis is possible when the intestinal muscles are not capable of peristalsis. The patient experiences flatulence - an accumulation of gases in the intestines. When preparing a patient for surgery, doctors think about this.

As a rule, the body receives enough sodium (table salt), but the level of potassium must be ensured. Repeated vomiting, diarrhea, and sweating lead to potassium loss. Heatstroke and sunstroke occur due to excessive sweating and loss of salts. The balance is disrupted. The same condition occurs if you play sports with heavy physical activity in the heat. A person starts drinking water, and this only worsens the situation; salt should be added to the water.

Potassium levels also decrease with injuries. But the main cause of hypokalemia is taking diuretics. When one problem in the body is eliminated, another appears.

When trying to restore the sodium-potassium balance in hypertension, they focus on sodium, although potassium is more important. It is harmful to over-salt food, but salt should be limited only in case of edema and cardiovascular diseases. And if you have hypertension, you need to think about taking potassium.

Electrolyte imbalance in the human body and concomitant potassium deficiency is associated with loss of energy and normal muscle contraction. Without potassium, glucose cannot be converted into energy or glycogen needed for energy expenditure. People cannot climb stairs without shortness of breath; their chronic fatigue is a sign of potassium deficiency. It is best to provide the body with potassium not through taking the drug, but through nutrition.

It turns out that someday you will need to think about it yourself: it’s one thing when you just get tired, it’s another thing when the muscles of your arms, legs, and intestines refuse to work. Maybe you should at least eat right? Necessary!

And what else you should think about yourself: how not to get into the vicious circle of treatment. For example, the desire to lose weight leads to taking diuretics, as a result of which potassium is lost, the cells begin to retain water, and the weight does not fall. Increasing your diuretic intake will lead to a decrease in blood sugar. Weakness, weakness, nervousness, and sleep disturbance will follow. And then there is a transition to medicinal drugs of a completely different direction.

Note. Need unrefined food products. Potassium-rich parsley, sunflower seeds, almonds, halibut, cod, turkey, chicken breasts, mushrooms, melon, avocado. Bananas don't have as much potassium as they say. There is more of it in orange juice. But both products contain a lot of sugar. Instead of table salt, it is better to use potassium chloride. Potassium deficiency must be identified by medical examination and its cause must be found.

Potassium metabolism disorders

Disorders of potassium metabolism in the form of hypokalemia or hyperkalemia accompany diseases of the gastrointestinal tract quite often.

Hypokalemia can be a consequence of diseases accompanied by vomiting or diarrhea, as well as when absorption processes in the intestine are impaired. It can occur under the influence of long-term use of glucose, diuretics, cardiac glycosides, adrenolytic drugs and during treatment with insulin. Insufficient or incorrect preoperative preparation or postoperative management of the patient - a diet poor in potassium, infusion of solutions that do not contain potassium - can also lead to a decrease in potassium content in the body.

Sodium metabolic disorders

Hyponatremia can also occur in the absence of external losses - with the development of hypoxia, acidosis and other reasons that cause an increase in the permeability of cell membranes. In this case, extracellular sodium moves inside the cells, which is accompanied by hyponatremia. Hypernatremia occurs against the background of oliguria, restriction of fluid intake, with excessive sodium administration, during treatment with glucocorticoid hormones and ACTH, as well as with primary hyperaldosteronism and Cushing's syndrome. It is accompanied by an imbalance of water balance - extracellular hyperhydration, manifested by thirst, hyperthermia, arterial hypertension, and tachycardia. Edema, increased intracranial pressure, and heart failure may develop. Hypernatremia is eliminated by prescribing aldosterone inhibitors (veroshpiron), limiting sodium intake and normalizing water metabolism.

Sodium deficiency causes a redistribution of fluid in the body: the osmotic pressure of the blood plasma decreases and intracellular hyperhydration occurs. Clinically, hyponatremia is manifested by rapid fatigue, dizziness, nausea, vomiting, decreased blood pressure, convulsions, and disturbances of consciousness. As you can see, these manifestations are nonspecific, and to clarify the nature of electrolyte imbalances and the degree of their severity, it is necessary to determine the sodium content in the blood plasma and erythrocytes. This is also necessary for directed quantitative correction. In case of true sodium deficiency, sodium chloride solutions should be used, taking into account the magnitude of the deficiency. In the absence of sodium losses, measures are necessary to eliminate the causes that caused the increase in membrane permeability, correction of acidosis, use of glucocorticoid hormones, proteolytic enzyme inhibitors, a mixture of glucose, potassium and novocaine. This mixture improves microcirculation, helps normalize the permeability of cell membranes, prevents the increased transition of sodium ions into cells and thereby normalizes sodium balance.

Calcium metabolism disorders

A decrease in calcium content in plasma is manifested by an increase in neuromuscular excitability, up to tetany, weakness, dizziness, and tachycardia. Therapy for hypocalcemic conditions and their prevention involve intravenous administration of calcium chloride or gluconate. The prophylactic dose of calcium chloride is 5-10 ml of a 10% solution, the therapeutic dose can be increased to 40 ml. It is preferable to carry out therapy with weak solutions - no higher than 1 percent concentration. Otherwise, a sharp increase in calcium levels in the blood plasma causes the release of calcitonin by the thyroid gland, which stimulates its transition to bone depots; in this case, the concentration of calcium in the blood plasma may fall below the initial level.

Magnesium metabolism disorders

Hypomagnesemia occurs with prolonged parenteral nutrition and pathological losses through the intestine, as magnesium is absorbed in the small intestine. Therefore, magnesium deficiency can develop after extensive resection of the small intestine, with diarrhea, intestinal fistulas, and intestinal paresis. The same disorder can occur against the background of hypercalcemia and hypernatremia, during treatment with cardiac glycosides, and with diabetic ketoacidosis. Magnesium deficiency is manifested by increased reflex activity, convulsions or muscle weakness, arterial hypotension, and tachycardia. Correction is carried out with solutions containing magnesium sulfate (up to 30 mmol/day).