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Essential Electrolytes: Functions & Testing

This document discusses the importance of electrolytes such as sodium, potassium, and chloride. Sodium is the major extracellular cation and regulates fluid balance and osmolality. Hypernatremia can result from excessive sodium intake or dehydration, while hyponatremia occurs with vomiting, diarrhea, or SIADH. Potassium is the major intracellular cation and regulates muscle and heart function. Hyperkalemia occurs in renal failure or medications, while hypokalemia results from vomiting, diarrhea, or medications. Chloride is the main extracellular anion and helps calculate the anion gap. Hyperchloremia can occur in acidosis, while hypochloremia happens with prolonged vomiting or alkalosis

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Krizzia Allyssa Cotingjo
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405 views4 pages

Essential Electrolytes: Functions & Testing

This document discusses the importance of electrolytes such as sodium, potassium, and chloride. Sodium is the major extracellular cation and regulates fluid balance and osmolality. Hypernatremia can result from excessive sodium intake or dehydration, while hyponatremia occurs with vomiting, diarrhea, or SIADH. Potassium is the major intracellular cation and regulates muscle and heart function. Hyperkalemia occurs in renal failure or medications, while hypokalemia results from vomiting, diarrhea, or medications. Chloride is the main extracellular anion and helps calculate the anion gap. Hyperchloremia can occur in acidosis, while hypochloremia happens with prolonged vomiting or alkalosis

Uploaded by

Krizzia Allyssa Cotingjo
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as DOC, PDF, TXT or read online on Scribd

ELECTROLYTES

Importance of Electrolytes
1. For volume and osmotic regulation
2. For myocardial rhythm and contractility
3. Important cofactors in enzyme activation
4. For regulation of ATPase ion pumps
5. For neuromuscular excitability
6. For the production and use of ATP from glucose

A. Sodium
- also known as “Natrium”
- major extracellular cation, major contributor of osmolality
- thirst is the major defense against hyperosmolality and hypernatremia
- plasma sodium concentration depends greatly on intake and excretion of H2O
- hormones affecting sodium levels : aldosterone and atrial natriuretic factor
(ANF)

Hypernatremia
1. Cushing syndrome
2. Diabetes insipidus
3. Dehydration
4. Certain types of brain injury
5. Excess ingestion of salt
6. Administration of hypertonic solution of sodium

Hyponatremia
1. Prolonged vomiting
2. Persistent diarrhea
3. Salt losing nephropathy
4. Potassium depletion
5. SIADH

Specimens : serum, heparinized plasma, urine, sweat, CSF


Normal value : serum 136-146 mmol/L

Methods
1. Flame Emission Spectrophotometry
2. Atomic Absorption Spectrophotometry
3. Ion Selective Electrode
4. Colorimetric method of Albanese Lein
Principle : Na is made to react with Zn uranyl acetate to produce Na uranyl
acetate.
after the addition of PVA. W/ the addition of water, a yellow
solution is
formed.

B. Potassium
- also known as “Kalium”
- major intracellular cation
- the concentration in RBC is 105 mmol/L
- Functions : regulation of neuromuscular excitability, heart contraction, ICF
Volume and hydrogen ion concentration

Specimen considerations:
1. Hemolysis of 0.5% RBC can increase levels by 0.5 mmol/L
2. Plasma levels are lower compared to serum level 90.1-0.7 mmol/L)
3. 10-20% increase as a result of muscle activity
4. Prolonged contact of serum and red cell
5. Prolonged application of tourniquet

Hyperkalemia
1. Addison’s disease
2. Hypoaldosteronism
3. Acute / chronic renal failure
4. Acidosis
5. Oral or IV potassium replacement therapy
6. Artifactual (sample hemolysis, thrombocytosis, prolonged tourniquet, excessive
fist clenching

Hypokalemia
1. Vomiting
2. Diarrhea
3. Use of large doses of laxatives
4. Diuretics
5. Cushing syndrome
6. Hyperaldosteronism
7. Insulin overdose

Specimens: serum, heparinized plasma, urine


Normal value : serum 3.4-5.0 mmol/L

Methods
1. Flame emission photometry
2. Atomic absorption spectrophotometry
3. Ion Selective Electrode
4. Colorimetric method of Lockhead and Purcell
K reacts w/ Na cobaltinitrite to produce NaK cobaltinitrite. With the addition
of
phenol, a blue color is produced.

C. Chloride
- major extracellular anion
- only anion to serve as enzyme activator
- excreted in urine and sweat
- useful in calculating anion gap
AG = (Na + K) – (Cl + HCO3) OR AG= Na – (Cl + HCO3)
NV: 10-20 mmol/L 7-16 mmol/L
Increased AG: severe renal disease, diabetic ketoacidosis, lactic acidosis,
Acute poisoning w/ aspirin, ethanol and ethylene glycol
Decreased AG: multiple myeloma, instrument error

- Functions: maintenance of blood volume, osmolality and electric neutrality

Hyperchloremia Hypochloremia
1. Renal tubular acidosis 1. Prolonged vomiting
2. Diabetes insipidus 2. Diabetic ketoacidosis
3. Metabolic acidosis 3. Aldosterone deficiency
4. Primary hyperparathyroidism 4. Salt losing renal diseases
Specimens: Serum, plasma, sweat
Normal value: 98-107 mmol/L

Methods
1. Mercurimetric Titration (Schales and Schales)
Cl + HgNO3 → HgCl2
Excess Hg + diphenylcarbazone → blue violet
2. Spectrophotometric
a. Mercuric thiocyanate (Whitehorn Titration method)
b. Ferric perchlorate
3. Ion Selective Electrode
4. Coulometric Amperometric Titration (Cotlove Chloridometer)

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