Maintaining electrolyte balance in the body. Blood electrolyte balance

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 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 case 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.

From this article you will learn:

• What is the water balance of the human body?
• What are the causes of imbalance in the body's water balance?
• How to recognize a violation of the body's water balance
• How to understand how much water is needed to maintain the body's water balance
• How to maintain a normal level of water balance in the body
• How can you restore water balance in the body?
• How is water imbalance in the body treated?

Everyone knows that a person is about 80% water. After all, water is the basis of blood (91%), gastric juice (98%), mucous membranes and other fluids in the human body. There is also water in our muscles (74%), about 25% in the skeleton, and, of course, it is present in the brain (82%). Therefore, water clearly affects the ability to remember, thinking and physical capabilities of a person. How to keep the body's water balance at a normal level to avoid health problems? You will learn about this from our article.

What is the body's water and electrolyte balance?

Water and electrolyte balance of the body is a set of processes of absorption and distribution of water throughout the human body and its subsequent removal.

When the water balance is normal, the amount of fluid released by the body is adequate to the incoming volume, that is, these processes are balanced. If you don’t drink enough water, the balance will turn out to be negative, which means that your metabolism will slow down significantly, your blood will become too thick and will not be able to distribute oxygen throughout the body in the required volume, your body temperature will rise and your heart rate will increase. It follows from this that the overall load on the body will be higher, but performance will decrease.

But drinking more water than you need can also be harmful. The blood will become too thin, and the cardiovascular system will receive greater stress. The concentration of gastric juice will also decrease, and this will lead to disruption of digestion processes. Excess water causes an imbalance in the water balance in the human body and forces the excretory system to work with increased load - excess fluid is excreted through sweat and urine. This not only leads to additional work for the kidneys, but also contributes to excessive loss of nutrients. All these processes ultimately disrupt the water-salt balance and significantly weaken the body.

Also, you should not drink a lot during physical activity. Your muscles will quickly get tired and you may even get cramps. You've probably noticed that athletes don't drink a lot of water during training and performances, but only rinse their mouths so as not to overload their hearts. Use this technique while jogging and training.

Why is the body's water-electrolyte balance disrupted?

The reasons for the imbalance are improper distribution of fluid throughout the body or its large losses. As a result, there is a deficiency of microelements that are actively involved in metabolic processes.

One of the main elements is calcium, its concentration in the blood may decrease, in particular, for the following reasons:

• disruptions in the functioning of the thyroid gland or its absence;
• therapy with medications containing radioactive iodine.

The concentration of another equally important microelement - sodium– may decrease for the following reasons:

• excess fluid consumption or its accumulation in body tissues due to various pathologies;
• therapy with diuretics (especially in the absence of medical supervision);
• various pathologies accompanied by increased urination (for example, diabetes);
• other conditions associated with fluid loss (diarrhea, increased sweating).

Shortage potassium occurs with alcohol abuse, taking corticosteroids, as well as with a number of other pathologies, for example:

• alkalization of the body;
• failure of adrenal function;
• liver diseases;
• insulin therapy;
• decreased thyroid function.

However, potassium levels may rise, which also upsets the balance.

Symptoms of water-salt imbalance in the human body

If during the day the body has used more fluid than it has received, then this is called negative water balance or dehydration. At the same time, tissue nutrition is disrupted, brain activity decreases, immunity decreases, and you may feel unwell.

Symptoms of negative water balance:

1. Dry skin. The top layers also become dehydrated and microcracks form on them.
2. Pimples on the skin. This occurs due to the fact that an insufficient amount of urine is released, and the skin is more actively involved in the process of removing toxins from the body.
3. Urine becomes darker due to lack of fluid.
4. Edema. They are formed due to the fact that the body tries to store water in different tissues.
5. You may also feel thirsty and have dry mouth. Little saliva is produced, a coating on the tongue and bad breath also appear.
6. Deterioration of brain function: symptoms of depression, sleep disturbances, poor concentration at work and household chores.
7. Due to lack of moisture, joints may ache and there is a risk of muscle spasms.
8. If there is not enough fluid in the body, this leads to constipation and a constant feeling of nausea.

Minerals (dissolved in water, called electrolytes) also affect the water-salt balance.

The most important are calcium (Ca), sodium (Na), potassium (K), magnesium (Mg), compounds with chlorine, phosphorus, bicarbonates. They are responsible for the most important processes in the body.

Negative consequences for the body will occur both with insufficient amounts of water and microelements, and with excess. Your body may not have enough water if you have had vomiting, diarrhea, or heavy bleeding. Children, especially newborns, feel the most severe lack of water in their diet. They have an increased metabolism, as a result of which the concentration of electrolytes and metabolic products in the tissues can very quickly increase. If excess of these substances is not eliminated promptly, it can pose a serious health threat.

Many pathological processes in the kidneys and liver lead to fluid retention in the tissues and cause an imbalance in the water balance in the body. If a person drinks too much, then water will also accumulate. As a result, the water-salt balance is disrupted, and this, in turn, causes not only disruptions in the functioning of various organs and systems, but can also lead to more severe consequences, such as pulmonary and cerebral edema, and collapse. In this case, a threat to human life already arises.

If a patient is hospitalized, the water and electrolyte balance of his body is not analyzed. Usually, drugs with electrolytes are prescribed immediately (of course, depending on the main diagnosis and severity of the condition), and further therapy and research are based on the body’s response to these drugs.

When a person is admitted to the hospital, the following information is collected and entered into his or her chart:

• information about health status and existing diseases. The following diagnoses indicate a violation of the water-salt balance: ulcers, gastrointestinal infections, ulcerative colitis, dehydration conditions of any origin, ascites, and so on. A salt-free diet also comes into focus in this case;
• the severity of the existing disease is determined and a decision is made on how treatment will be carried out;
• Blood tests are performed (according to the general scheme, for antibodies and bacterial cultures) to clarify the diagnosis and identify other possible pathologies. Usually other laboratory tests are carried out for this purpose.

The sooner you establish the cause of the disease, the sooner you can eliminate problems with your water-salt balance and quickly organize the necessary treatment.

Calculation of water balance in the body

The average person needs about two liters of water per day. You can accurately calculate the required volume of liquid using the formula given below. A person gets about one and a half liters from drinks, and almost a liter comes from food. Also, part of the water is formed due to the oxidation process in the body.

To calculate the amount of water you need per day, you can use the following formula: multiply 35–40 ml of water by body weight in kilograms. That is, it is enough to know your own weight to instantly calculate your individual need for water.

For example, if your weight is 75 kg, then using the formula we calculate the volume you need: multiply 75 by 40 ml (0.04 l) and get 3 liters of water. This is your daily fluid intake to maintain normal water-salt balance in the body.

Every day the human body loses a certain amount of water: it is excreted through urine (about 1.5 l), through sweat and breathing (about 1 l), through the intestines (about 0.1 l). On average this amount is 2.5 liters. But the water balance in the human body is very dependent on external conditions: ambient temperature and the amount of physical activity. Increased activity and heat cause thirst, the body itself tells you when it is necessary to replenish fluid loss.

At high air temperatures, our body heats up. And overheating can be very dangerous. Therefore, the thermoregulation mechanism is immediately activated, based on the evaporation of liquid by the skin, due to which the body cools. About the same thing happens during an illness with a high temperature. In all cases, a person needs to replenish fluid loss, take care of restoring the water-salt balance in the body by increasing water consumption.

In comfortable conditions at an air temperature of about 25 ° C, the human body secretes about 0.5 liters of sweat. But as soon as the temperature begins to rise, the secretion of sweat also increases, and each additional degree causes our glands to part with another hundred grams of liquid. As a result, for example, in 35-degree heat, the amount of sweat secreted by the skin reaches 1.5 liters. In this case, the body reminds you of the need to replenish your fluid supply with thirst.

How to maintain water balance in the body

So, we have already found out how much water a person needs to consume during the day. However, it is important in what mode the liquid enters the body. It is necessary to evenly distribute water intake during the waking period. Thanks to this, you will not provoke swelling and will not force the body to suffer from water deficiency, which will bring it maximum benefit.

How to normalize water balance in the body? Many people drink water only when thirsty. This is a big mistake. Thirst means you are already dehydrated. Even when it is very minor, it still has a big impact on the body. Remember that you should not drink a lot during breakfast, lunch and dinner, or immediately after meals. This will significantly reduce the concentration of gastric juice and worsen digestion processes.

How to restore water balance in the body?

It is best to create a water intake schedule for yourself, for example this:

• One glass 30 minutes before breakfast to start the stomach working.
• One and a half to two glasses a couple of hours after breakfast. It could be tea at work.
• One glass 30 minutes before lunch.
• One and a half to two glasses a couple of hours after lunch.
• One glass 30 minutes before dinner.
• One glass after dinner.
• One glass before going to bed.

In addition, you can drink one glass during meals. As a result, we get the required amount of water in twenty-four hours. The proposed drinking schedule ensures a uniform supply of water to the body, which means you will not need to worry about swelling or dehydration.

To maintain a normal water-salt balance, one should not forget about the following factors:

1. During physical activity, a lot of salts leave the body along with sweat, so it is better to drink water with salt, soda, mineral water or water with sugar.
2. Increase the amount of water consumed if the ambient temperature is elevated.
3. Also drink more water if you are in a dry room (where radiators are very hot or the air conditioner is running).
4. When taking medications, consuming alcohol, caffeine, or smoking, the level of water in the body also decreases. Be sure to replenish losses with additional fluid.
5. Water comes not only with coffee, tea and other drinks. Eat vegetables, fruits and other foods that are high in fluids.
6. The body also absorbs water through the skin. Take a shower more often, lie in the bath, swim in the pool.

With a uniform supply of water, your metabolism will improve, energy will be produced constantly during the period of activity and you will not be so tired from work. Also, maintaining water balance in the body will prevent the accumulation of toxins, which means that the liver and kidneys will not be overloaded. Your skin will become more elastic and firm.

How to restore water-salt balance in the body

Excessive loss of fluid or insufficient supply of fluid for a person is fraught with failures of various systems. How to restore water-salt balance in the body? You need to understand that the water deficit cannot be filled at one time, so you do not need to drink in large portions. Fluid should be supplied to the body evenly.

The state of dehydration is also accompanied by sodium deficiency, so you need to drink not just water, but various solutions with electrolytes. You can buy them at the pharmacy and simply dissolve them in water. But if dehydration is severe enough, you should immediately seek medical help. This is especially important for children; if there are any signs of dehydration in a small child, you must call an ambulance. The same applies to older people.

In case of oversaturation of tissues and organs with water, there is no need to independently restore the water-salt balance in the body. Consult your doctor to find out the problem that caused this condition. It is often a symptom of a disease and requires treatment.

What to do to avoid dehydration:

• Always drink if you are thirsty. Be sure to take a water bottle of at least one liter with you.
• Drink more during physical activity (an adult can drink one liter per hour, a child needs 0.15 liters). Although it should be noted that experts are not unanimous on this issue.

A person who does not drink fluids responsibly is at risk of dehydration or swelling. Do not under any circumstances disturb the water balance in the body. Carefully monitor the amount of fluid in your body.

Treatment of water-electrolyte imbalance in the human body

Restoring the water-salt balance in the body is very important for the well-being and functioning of organs. Below is a general scheme according to which the health status of patients with these problems in medical institutions is normalized.

• First, you need to take measures to prevent the development of a pathological condition that poses a threat to human life. To do this, immediately liquidate:

1. bleeding;
2. hypovolemia (insufficient blood volume);
3. deficiency or excess of potassium.

• To normalize the water-salt balance, various solutions of basic electrolytes in dosage form are used.
• Measures are being taken to prevent the development of complications as a result of this therapy (in particular, with injections of sodium solutions, epileptic attacks and manifestations of heart failure are possible).
• In addition to drug treatment, diet is possible.
• The administration of drugs intravenously is necessarily accompanied by monitoring the level of water-salt balance, acid-base status, and hemodynamics. It is also necessary to monitor the condition of the kidneys.

If a person is prescribed intravenous administration of saline solutions, a preliminary calculation of the degree of water-electrolyte imbalance is made and, taking this data into account, a plan of therapeutic measures is drawn up. There are simple formulas based on standard and actual indicators of sodium concentration in the blood. This technique makes it possible to determine disturbances in the water balance in the human body; the calculation of fluid deficiency is carried out by a doctor.

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Water-electrolyte imbalance is a condition that occurs when there is a lack or excess of water and vital electrolytes in the body: potassium, magnesium, sodium, calcium. The main types of pathology: dehydration (dehydration) and hyperhydration (water intoxication).

A pathological condition develops when the supply of fluid and electrolytes does not meet the needs of the body or the mechanisms of excretion and regulation are disrupted.

Symptoms

Clinical manifestations and their severity depend on the type of pathology, the rate of development of changes, and the depth of the disorders.

Dehydration

Dehydration occurs when water loss exceeds water supply. Symptoms of dehydration appear when the fluid deficit reaches 5% of body weight. The condition is almost always accompanied by an imbalance of sodium, and in severe cases, other ions.

When dehydrated, blood viscosity increases and the risk of thrombosis increases.

Overhydration

Pathology develops when the intake of water is greater than its release. The fluid does not remain in the blood, but passes into the intercellular space.

Main manifestations:

Dehydration and overhydration are accompanied by various electrolyte disturbances, each of which has its own symptoms.

Imbalance of potassium and sodium

Potassium is the main intracellular ion. It is involved in protein synthesis, electrical activity of the cell, and glucose utilization. Sodium is contained in the intercellular space and is involved in the functioning of the nervous and cardiovascular systems and the exchange of carbon dioxide.

Hypokalemia and hyponatremia

Symptoms of potassium and sodium deficiency are similar:

Hyperkalemia

• rare pulse, in severe cases cardiac arrest is possible;
• chest discomfort;
• dizziness;
• weakness.

Hypernatremia

• swelling;
• increased blood pressure.

Calcium imbalance

Ionized calcium is involved in the functioning of the heart, skeletal muscles, and blood clotting.

Hypocalcemia

• convulsions;
• paresthesia - a burning sensation, crawling, tingling of the arms and legs;
• attacks of palpitations (paroxysmal tachycardia).

Hypercalcemia

• increased fatigue;
• muscle weakness;
• rare pulse;
• disruption of the digestive system: nausea, constipation, bloating.

Magnesium imbalance

Magnesium has an inhibitory effect on the nervous system and helps cells absorb oxygen.

Hypomagnesemia

Hypermagnesemia

• weakness;
• drowsiness;
• rare pulse;
• rare breathing (with a pronounced deviation from the norm).

Methods for restoring water and electrolyte homeostasis

The main condition for restoring the balance of water and electrolytes in the body is to eliminate the cause that provoked the disorder: treatment of the underlying disease, adjustment of the dose of diuretics, adequate infusion therapy after surgery.

Depending on the severity of symptoms and the severity of the patient’s condition, treatment is carried out on an outpatient basis or in a hospital.

Treatment at home

At initial signs of electrolyte imbalance, tablet preparations containing microelements are prescribed. A prerequisite is the absence of vomiting and diarrhea.

For vomiting and diarrhea. Its purpose is to restore the lost volume of fluid, providing the body with water and electrolytes.

What drink:

The ratio of electrolyte and salt-free solutions depends on the path of fluid loss:

• vomiting predominates - take salt and salt-free medications in a 1:2 ratio;
• vomiting and diarrhea are expressed equally – 1:1;
• diarrhea predominates – 2:1.

With timely initiation and proper implementation, the effectiveness of treatment reaches 85%. Until the nausea stops, drink 1-2 sips every 10 minutes. If you feel better, increase the dose.

Treatment in hospital

If the condition worsens, hospitalization is indicated. In the hospital, fluid with electrolytes is administered intravenously by drip. To select a solution, volume, and rate of administration, the amount of sodium, potassium, magnesium, and calcium in the blood is determined. The daily amount of urine, pulse, blood pressure, and ECG are assessed.

• solutions of sodium chloride and glucose of various concentrations;
• Acesol, Disol - contain acetate and sodium chloride;
• Ringer's solution - contains sodium, potassium, chlorine, sodium, calcium ions;
• Lactosol - contains sodium lactate, potassium, calcium, magnesium chlorides.

For overhydration, diuretics are prescribed intravenously: Mannitol and Furosemide.

Prevention

If you suffer from one disease that is accompanied by imbalances in water and electrolytes, take preventive measures. Take potassium and magnesium supplements at the same time as diuretics. For intestinal infections, start oral rehydration promptly. Follow a diet and drinking regimen for kidney and heart diseases.

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.

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.

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:

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, hyponatremia may not mean a general sodium deficiency, although in this case it is often observed.

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:

Injury 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;

The excess of potassium losses over its intake is accompanied by hypopotassium 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

Stada Arzneimittel Germany

Samson-Med LLC Russia

LLC "Farmland" Republic of Belarus

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:

1. Antihypoxic effect,
2. Removal of toxins,
3. Increased strength of heart contractions,
4. Normalization of heart rate,
5. Maintaining optimal functioning of immunocompetent cells,
6. 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:

1. Excessive physical activity
2. Psycho-emotional stress,
3. Alcoholism,
4. Excessive consumption of coffee and sweets,
5. Taking diuretics
6. Diets,
7. Massive swelling,
8. Dyspepsia,
9. Hypoglycemia,
10. Cystic fibrosis,
11. 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:

1. Refusal of salty foods,
2. Dehydration resulting from repeated vomiting or prolonged diarrhea
3. Hyperthermia,
4. Loading doses of diuretics,
5. Hyperglycemia,
6. Hyperhidrosis,
7. Prolonged shortness of breath,
8. Hypothyroidism,
9. nephrotic syndrome,
10. Heart and kidney diseases,
11. Polyuria,
12. 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:

1. Vomit,
2. Hyperhidrosis,
3. Treatment with large doses of diuretics,
4. Acidotic coma,
5. 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:

1. Bone formation disorders in children,
2. Bone loss,
3. Lack of thyroid hormones in the blood,
4. Inflammatory and degenerative processes in the pancreas,
5. Magnesium deficiency
6. Violation of the bile excretion process,
7. Liver and kidney dysfunction,
8. Long-term use of cytostatics and antiepileptic drugs,
9. 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:

1. Iron-deficiency anemia,
2. Lack of vitamins
3. Infections,
4. Oncopathology,
5. Massive blood loss
6. Gastrointestinal dysfunctions,
7. Taking NSAIDs and glucocorticosteroids,
8. 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:

1. Impaired fat metabolism, steatorrhea,
2. Inflammation of the glomerular apparatus of the kidneys,
3. Hypofunction of growth hormone,
4. Vitamin D deficiency
5. Hypokalemia,
6. Poor nutrition
7. Deposition of urate in joints,
8. Overdose of insulin, salicylates,
9. 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 gender and age of the patient.

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.

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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 and remain 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.

What causes an imbalance in the water-salt balance in the body, and what consequences can this imbalance cause?

Two phenomena - one problem

The water-electrolyte (water-salt) balance can be disturbed in two directions:

1. Overhydration– excessive accumulation of fluid in the body, slowing down the elimination of the latter. It accumulates in the intercellular space, its level inside the cells increases, and the latter swell. When nerve cells are involved in the process, nerve centers are excited and convulsions occur;
2. Dehydration is the opposite phenomenon to the previous one. The blood begins to thicken, the risk of blood clots increases, and blood flow in tissues and organs is disrupted. With a deficiency of more than 20%, death occurs.

Violation of the water-salt balance is manifested by weight loss, dry skin and cornea. With severe moisture deficiency, subcutaneous fatty tissue resembles the consistency of dough, the eyes become sunken, and the volume of circulating blood decreases.

Dehydration is accompanied by aggravation of facial features, cyanosis of the lips and nails, low blood pressure, weak and rapid pulse, hypofunction of the kidneys, and increased concentration of nitrogenous bases due to impaired protein metabolism. Also, a person’s upper and lower extremities are cold.

There is such a diagnosis as isotonic dehydration - loss of water and sodium in equal quantities. This occurs in acute poisoning, when electrolytes and fluid volume are lost through diarrhea and vomiting.

Why there is a lack or excess of water in the body

The main causes of the pathology are external fluid loss and redistribution of water in the body. Blood calcium levels decrease:

• with pathologies of the thyroid gland or after its removal;
• when radioactive iodine preparations are used (for treatment);
• with pseudohypoparathyroidism.

Sodium decreases in long-term diseases accompanied by decreased urine output; in the postoperative period; with self-medication and uncontrolled use of diuretics.

1. Potassium decreases as a result of its intracellular movement;
2. With alkalosis;
3. Aldosteronism;
4. Corticosteroid therapy;
5. Alcoholism;
6. Liver pathologies;
7. After operations on the small intestine;
8. With insulin injections;
9. Thyroid hypofunction.

The reason for its increase is an increase in catitones and a delay in its compounds, damage to cells and the release of potassium from them.

Symptoms and signs of water-salt imbalance

The first warning signs depend on what is happening in the body - overhydration or dehydration. This includes:

• swelling;
• vomit;
• diarrhea;
• strong thirst.

1. The acid-base balance often changes, blood pressure decreases, there is an arrhythmic heartbeat. These symptoms cannot be ignored, as progressive pathology leads to cardiac arrest and death.
2. Calcium deficiency leads to smooth muscle spasms. Spasm of large vessels and the larynx is especially dangerous. An excess of this element causes stomach pain, severe thirst, vomiting, frequent urination, and poor circulation.
3. Potassium deficiency is accompanied by alkalosis, atony, chronic renal failure, intestinal obstruction, brain pathologies, ventricular fibrillation of the heart and other changes in its rhythm.
4. As its concentration increases in the body, ascending paralysis occurs, nausea, vomiting. This condition is very dangerous, since fibrillation of the heart ventricles develops very quickly, that is, there is a high probability of atrial arrest.
5. Excess magnesium occurs with abuse of antacids and kidney dysfunction. This condition is accompanied by nausea, leading to vomiting, fever, and slow heart rate.

The role of the kidneys and urinary system in the regulation of water-salt balance

The function of this paired organ is aimed at maintaining the constancy of various processes. They answer:

• for ion exchange occurring on both sides of the canalicular membrane;
• removal of excess cations and anions from the body through adequate reabsorption and excretion of potassium, sodium and water.

The role of the kidneys is very important, since their functions make it possible to maintain a stable volume of intercellular fluid and an optimal level of substances dissolved in it.

A healthy person needs about 2.5 liters of fluid per day. He receives approximately 2 liters through food and drink, 1/2 liter is formed in the body itself as a result of metabolic processes. One and a half liters are excreted by the kidneys, 100 ml by the intestines, 900 ml by the skin and lungs.

The amount of fluid excreted by the kidneys depends on the condition and needs of the body itself. With maximum diuresis, this organ of the urinary system can excrete up to 15 liters of fluid, and with antidiuresis - up to 250 ml.

Sharp fluctuations in these indicators depend on the intensity and nature of tubular reabsorption.

Diagnosis of water-salt balance disorders

During the initial examination, a presumptive conclusion is made; further therapy depends on the patient’s response to the administration of antishock drugs and electrolytes.

The doctor makes a diagnosis based on the patient’s complaints, medical history, and research results:

1. Anamnesis. If the patient is conscious, he is interviewed and information about water and electrolyte imbalances is clarified (diarrhea, ascites, peptic ulcer, narrowing of the pylorus, severe intestinal infections, some types of ulcerative colitis, dehydration of various etiologies, short-term low-salt diets on the menu) ;
2. Setting the degree of pathology, carrying out measures to eliminate and prevent complications;
3. General, bacteriological and serological blood tests to identify the cause of the deviation. Additional laboratory and instrumental studies may be prescribed.

Modern diagnostic methods make it possible to determine the cause of the pathology, its degree, and also to promptly begin to relieve symptoms and restore human health.

How can you restore the water-salt balance in the body?

Therapy involves the following activities:

• Conditions that can become life threatening are relieved;
• Eliminates bleeding and acute blood loss;
• Hypovolemia is eliminated;
• Hyper- or hyperkalemia is eliminated;
• It is necessary to take measures to regulate normal water-electrolyte metabolism. Most often, glucose solution, polyionic solutions (Hartmann, lactasol, Ringer-Lock), red blood cell mass, polyglucin, soda are prescribed;
• It is also necessary to prevent the development of possible complications - epilepsy, heart failure, in particular during therapy with sodium drugs;
• During recovery with the help of intravenous saline solutions, it is necessary to monitor hemodynamics, renal function, the level of CBS, and ECO.

Drugs that are used to restore water-salt balance

1. Potassium and magnesium aspartate– required for myocardial infarction, heart failure, artymia, hypokalemia and hypomagnesemia. The drug is well absorbed when taken orally, excreted by the kidneys, transports magnesium and potassium ions, and promotes their entry into the intercellular space.
2. Sodium bicarbonate– often used for peptic ulcers, gastritis with high acidity, acidosis (intoxication, infection, diabetes), as well as for kidney stones, inflammation of the respiratory system and oral cavity.
3. Sodium chloride - is used for a lack of intercellular fluid or its large loss, for example, for toxic dyspepsia, cholera, diarrhea, uncontrollable vomiting, severe burns. The drug has a rehydrating and detoxifying effect, allowing you to restore water and electrolyte metabolism in various pathologies.
4. Sodium citrate - helps restore normal blood counts. This product increases sodium concentration.
5. Hydroxyethyl starch (PeoHES)– the product is used for surgical interventions, acute blood loss, burns, infections as a prevention of shock and hypovolemia. It is also used for microcirculation deviations, as it promotes the distribution of oxygen throughout the body and restores capillary walls.

Maintaining natural water-salt balance

This parameter can be violated not only with serious pathologies, but also with profuse sweating, overheating, uncontrolled use of diuretics, and a long-term salt-free diet.