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Main > Kidney Disease > Renal Failure > Renal Failure Diagnosis >
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Abnormal Metabolism Of Electrolyte And Acid-Base

2019-01-27 13:34

Electrolyte And Acid-Base,Abnormal Metabolism,ElectrolyteMost of Kidney Failure will occur abnormal metabolism of electrolyte and acid-base, so what are the accurate abnormal metabolism of substance, following this article to get answer, or you can consult ONLINE DOCTOR directly in free.

(1) Water metabolism: In the early stage, due to the decline of concentration function, urine volume decreases or increases, but in the late stage, urine volume decreases, and in the end, it can develop to anuria. The patients' ability to regulate water metabolism declines. When water intake is excessive, it is easy to retain and form dilute hyponatremia in the body. When water intake is too low, it is also easy to cause water deficiency in the body.

(2) Potassium metabolism: There is a tendency of hyperkalemia. The accumulation of intracellular potassium is related to the decrease of Na+-K+-ATP activity. Hyperkalemia can be aggravated by trauma, surgery, anesthesia, blood transfusion, acidosis, sudden change of diet, etc. The increase of blood potassium in chronic renal failure is one aspect, but the total potassium storage is still reduced, so it is still important to maintain the normal balance of potassium.

(3) Sodium metabolism: CRF can maintain the normal balance of sodium for a long time, which is related to the survival of renal units and natriuretic hormones and other humoral factors.

Sodium consumption type: Salt loss nephropathy has sodium loss due to the reduction of extracellular fluid and hypotension. Many diseases can cause salt loss, such as pyelonephritis, renal medullary cystic disease, hydronephrosis, interstitial nephritis and so on. The collecting ducts of these patients often fail to absorb enough sodium salt transported to them, resulting in hyponatremia.

Sodium retention type: when*intake*of sodium is too much, it can not be excreted normally, resulting in sodium retention, increased extracellular capacity in vivo, hypertension, pulmonary congestion, heart enlargement and even heart failure.

(4) Acid-base balance: In the early stage of chronic renal failure, the compensatory ability of renal tubular ammonia synthesis is not completely lost, and other buffer systems can be mobilized to compensate for metabolic acidosis, such as respiratory system, tissue compensation, such as bone salt loss. When the disease progresses, the number of surviving nephron is further reduced, and GFR is less than 20 ml/min, the ability of kidney to excrete organic acids decreases, ammonia excretion ability decreases and acidosis is occurs. When blood pH < 7.25, we should be alert to ketoacidosis.

(5) Other electrolytes: patients with chronic renal failure can not excrete chloride ions adequately, hyperchloremia is proportional to sodium concentration; blood calcium concentration is often reduced, patients with chronic renal failure can tolerate hypocalcemia without convulsion, these patients'intestinal calcium absorption ability is reduced, oral active vitamin D can improve blood calcium concentration;

When GFR was less than 20 ml/min, serum magnesium increased and urinary magnesium excretion decreased. Most patients are asymptomatic and need no treatment. When the serum magnesium level is higher (>2 mmol/L) with clinical symptoms, sodium and diuretics can be used to promote magnesium excretion, correct dehydration, and Dialysis therapy if necessary. When GFR is less than 20 ml/min, the serum phosphorus level increases obviously, and the renal phosphorus excretion rate further decreases.

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Tag: Electrolyte Electrolyte And Acid-Base Abnormal Metabolism

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