This is a great question to think about electrolytes and how the kidneys (or lack of healthy ones) affect them. Each one will be hypo or hyper and then of course FVE or FVD and the acid base status.
A 50 year old female with renal disease was admitted to the hospital following a seizure. What fluid, electrolyte and/or acid-base disturbances would you suspect with this patient?
• Calcium
• Magnesium
• Phosphorus
• Potassium
• Sodium
• Fluid
• Acid-Base
ANSWER: Hypermagnesemia, hyperphosphatemia, hyponatremia, hyperkalemia, Metabolic Acidosis, FVE, hypocalcemia.
As the Acidosis forms, calcium bound to protein is released, and then moves out of vascular space to muscles. This brings the level of Ca down. Serum Ph has an inverse relationship with ionized calcium level. Serum ph rises and blood becomes more alkaline: more calcium binds with protein, ionized calcium levels drop. Vice versa in acidosis. When the acidosis occurs the calcium breaks its bond with calcium, once free, the calcium moves out of vessels to muscles...causing a serum drop. Hence you get the hypocalcemia.