Electrolytes:

Sodium, Potassium, Chloride and Calcium

Group 1 - MT3A
Busio, Mary Claire
Infantado, Czekiah
Perez, Mikaela
Tulin, Lovely Heart
Ubas, Mike Jimwel
 Electrolytes
Electrolytes are ions capable of carrying an electric charge. Fluid always contains equal numbers of
cations and anions, and this balance of charges is referred to as electroneutrality. Dissociation of
solutes into charged particles (ions) depends on the chemical composition of the compound and on
the concentration of other charged particles in the medium.

The volume of the extracellular fluid varies on water retention controlled by the arginine
vasopressin and sodium retention is regulated by aldosterone. On the contrary, intracellular fluids
are made to be stable with constant osmolality because of the chemical reactions that take place in
that cellular space with 60% of the body's water inside the cells and the remaining is in the
bloodstream or tissue fluids.
 Electrolytes
Functions of Electrolytes
Sodium (Na⁺)
It is also known as "natrium."
It is the major extracellular cation, hence the major contributor of osmolality.
It is the principal osmotic particle outside the cell.
Its plasma concentration depends greatly on the intake and excretion of water.
Its level in blood is an important determinant of several biological pathways in the
nervous system.
Extracellular volume depends primarily on plasma Na+, which is closely regulated by
AVP (water retention) and aldosterone (sodium retention).
All confirmed serum sodium abnormalities must be monitored together with urine
sodium and osmolality including urinalysis.
Na+/K+-ATPase ion pump moves three Na+ ions out of the cell in exchange for two
K+ ions moving into the cell as
ATP is converted to ADP.
Potassium (K⁺)
It is otherwise known as "kalium."
It is the major intracellular cation, and only 2% of the body's total potassium circulates in
plasma.
It is the single most important analyte in terms of an abnormality being immediately life
threatening.
Its concentration in the red blood cells is 105 mmol/L or 23x its concentration in plasma.
In the ascending limb of Henle's loop, it is reabsorbed together with Nat and Cl- by the
sodium potassium chloride co-transporter.
It is filtered at the glomeruli and is mostly (70%-80%) reabsorbed by active and passive
mechanisms in the proximal tubule.
It is involved in cardiac contraction, neuromuscular excitability, ICF volume regulation,
and hydrogen ion concentration-K has a major effect on the contraction of skeletal and
cardiac muscles.
Its plasma concentration is greatly influenced by the kidneys and aldosterone. Important
in the regulation of K+ balance: Tubular reabsorption and secretion
Chloride (Cl⁻)
It is the major extracellular anion.
It is the chief counter ion of sodium in ECF.
Promotes maintenance of water balance and osmotic pressure in conjunction
with sodium, an enzyme activator and maintains electroneutrality.
The only anion to serve as an enzyme activator.
lt is excreted in the urine and sweat.
Disorders of chloride are the same as sodium since they are both extracellular
cations.
lts concentration is influenced by aldosterone.
Calcium (Ca²⁺)
It is present almost exclusively in plasma.
It is involved in blood coagulation, enzyme activity excitability of skeletal and
cardiac muscle, and maintenance of blood pressure.
It is maximally absorbed in the duodenum and absorption of favored at an
acidic pH.
An increase in intestinal pH (alkalinity) reduces calcium absorption.
99% of calcium is part of bones and 1% is in th3 ecf and soft tissues.
Discovery & History
Electrolytes can be traced to ancient Egypt and Greece, where the significance of maintaining
balance within the body was recognized, particularly concerning salts.
In 1802, Jöns Jacob Berzelius found that an electric current could split molecules, particularly
salts, into positive and negative parts.
The word electrolyte was created by Faraday in his famous treatise of 1834 when he was trying
to explain why certain aqueous solutions can conduct electricity when placed between a pair of
“electric poles” polarized by a voltaic pile (which was the very first battery, invented by
Alessandro Volta in 1799), laying the foundation for electrochemistry.
Faraday, therefore, coined a new word from ancient Greek etymology ήλεκτρολυτός
(electrolytes), where the prefix ήλεκτρο (ēlectro-) indicates “electricity”, while λυτός (lytos)
implies that it is “able to be taken apart”.
Sodium
Sodium was first isolated in 1807 by Humphry Davy through electrolysis of caustic soda​.
Its symbol, Na, comes from natrium, the Latin name for sodium carbonate, which was
historically used as a headache remedy.
Potassium
Potassium was discovered in 1807 by Humphry Davy, who isolated it via electrolysis of molten
caustic potash.
Its name originates from "potash" (pot ashes), reflecting its early extraction from wood ash.
Chloride
Chlorine was first produced in 1774 by Carl Wilhelm Scheele, though he didn't recognize it as
an element.
Humphry Davy confirmed it as an element in 1810 and named it after the Greek word for
greenish-yellow, reflecting its color
Chloride is the anionic form of chlorine, meaning it carries a negative charge.
Calcium
Calcium was isolated in 1808 by Humphry Davy through electrolysis of lime.
Its name comes from the Latin word "calx," meaning lime
 Types of Electrolytes
Deficiency Excess
Electrolyte Function Food Sources
Effects Effects
Hyponatremia Hypernatremia
Fluid balance, Salt, cheese,
Sodium (Na⁺) (confusion, (dehydration, high
nerve function processed foods
seizures) BP)

Heart function, Hypokalemia Hyperkalemia

Potassium Bananas, spinach,
muscle (weakness, (irregular
(K⁺) beans
contraction cramps) heartbeat)

Acid-base Hypochloremia
Hyperchloremia Table salt,
Chloride (Cl⁻) balance, (vomiting,
(kidney problems) seaweed, olives
digestion alkalosis)

Bone strength, Hypocalcemia

Hypercalcemia Milk, cheese,
Calcium (Ca²⁺) muscle (spasms,
(kidney stones) almonds
movement osteoporosis)
 Diseases Involved

The humans become

dehydrated when they
consume less fluid than
Dehydration their bodies use resulting
in physiological imbalances
between sodium and
potassium.

The kidneys maintain

electrolyte balance which
Kidney Disease makes impaired kidney
function result in health
problems affecting the
entire body.
 Diseases Involved

The function of muscles

strongly depends on
electrolyte levels because
Muscle Cramps their imbalance leads to
unwanted involuntary
contractions along with
cramps.

A disorder called
osteoporosis forms due to
Osteoporosis weakened bones which
results from calcium
imbalance.
Critical Conditions
SODIUM (Na+)
Hyponatremia (Low Na+)
Causes: Excessive water intake, Kidney Disease, SIADH (Syndrome of Inappropriate ADH)
Symptoms: Nausea, Headache, seizure, Coma
Treatment: Fluid Restriction, Hypertonic saline (3% NaCl)
Hypernatremia (High Na+)
Causes: Dehydration, Hyperaldosteronism (Conn's Disease)
Symptoms: Intense thirst, dry mucous membrane, confusion, muscle twitching, seizures
Treatment: Rehydration with hypotonic IV fluid
Pseudohyponatremia
Causes: Hyperlipidemia, Diabetic Ketoacidosis
Symptoms: Hypertricglyceridemia
Treatment: Ion-Selective Electrode Testing
Critical Conditions

POTASSIUM (K+)
Hypokalemia (High Potassium)
Causes: Diuretics, Vomiting, diarrhea, metabolic alkalosis, insulin theraphy
Symptoms: Muscle weakness, cramps, fatigue, Cardiac arrhythmias
Treatment: Oral or IV potassium supplementation

Hyperkalemia (Low Potassium)

Causes: Kidney failure, Tissue damage, acidosis
Symptoms: Muscle weakness, numbness, life-threatening arrythmias
Treatment: Calcium gluconate, Insulin + glucose, Dialysis
Critical Conditions

CHLORIDE (Cl-)
Hypochloremia (Low Chloride)
Causes: Vomiting, Metabolic alkalosis, Chronic respiratory acidosis
Symptoms: Dehydration, Tetany
Treatment: IV normal saline, potassium chloride
Hyperchloremia (High Chloride)
Causes: Dehydration, Excessive saline, Metabolic acidosis
Symptoms: Fatigue, deep and rapid breathing
Treatment: IV lactated Ringer’s solution, Bicarbonate therapy
Critical Conditions

CALCIUM (Ca2+)
Hypocalcemia (Low Calcium)
Causes: Hypoparathyroidism, Vitamin D deficiency, CKD
Symptoms: Muscle Spasms, tetany, seizures, cardiac arrythmias
Treatment: IV calcium gluconate and Vitamin D supplements
Hypercalcemia (High Calsium)
Causes: Hyperparathyroidism, Malignancies, Excessive Vitamin D or calcium intake
Symptoms: KIdney stones, constipation, weakness, confusion
Treatment: Hydration, Biphosphonates
 Clinical Significance
INCREASE DECREASE

Sodium
Regulates fluid
balance, blood
pressure, nerve
and muscle
function.
Imbalances
indicate underlying
medical conditions.
 Clinical Significance
DECREASE
INCREASE
Potassium
Essential for nerve,
muscle, and heart
function.
Critical for
preventing
morbidity and
mortality.
 Clinical Significance
Chloride
Controls body fluid INCREASE DECREASE
(HYPERCHLOREMIA) (HYPOCHLOREMIA)
amount, blood
volume, and blood 1. Renal tubular acidosis
pressure. 2. Diabetes insipidus
1. Prolonged vomiting
Maintains 3. Salicylate intoxication
2. Aldosterone deficiency
electroneutrality 4. Primary
3. Metabolic alkalosis
and acid-base hyperparathyroidism
4. Salt-losing nephritis
balance. 5. Metabolic acidosis
Indicates 6. Prolonged diarrhea
underlying
metabolic
disorders.
 Clinical Significance
INCREASE DECREASE
Calcium
Essential for bone
structure, nerve
and muscle activity,
heart function,
blood clotting, and
cell function.
Dysregulation
indicates adverse
effects and
diseases
Test Methodology (Na, K, Cl, & Ca)

1. Collect 5 mL venous blood in red-top evacuated tube.

2. Allow the tube to stand for 30 minutes and separate the serum by
centrifugation
at 3000-3500 rpm for 10 - 15 minutes.
3. Do not use hemolyzed serum, icteric and lipemic samples.
4. Process the sample within 2 hours of collection.
5. Separate the serum as soon as possible.
6. If analysis will be delayed, serum can be stored at 2 - 8C for 8 hours.
7. Prepare and reconstitute the reagents and other consumables (please follow
the specific instruction of the manufacturer:
a. Buffer
b. Substrate
c. Working Reagent
Test Methodology (Na, K, Cl, & Ca)

8. Add the reagents in the cuvet, followed by the serum.

9. Turn on the spectrophotometer.
10. Run a water blank to set the spectrophotometer to zero.
11. Adjust the desired wavelength according to the reagent kit specification.
12. Run the sample in the spectrophotometer.
13. Read the absorbance and compute for the concentration of the analyte.
Normal Values

Normal Values

Sodium (Na⁺) 135-145 mmol/L

Potassium (K⁺) 3.5-5.1 mmol/L

Chloride (Cl⁻) 98-107 mmol/L

Total Calcium =
Calcium (Ca²⁺) Adult: 8.8-10 mg/dL (2.15-2.5 mmol/L)
Child: 8.8-10.8 mg/dL (2.2-2.7 mmol/L)
Reference/s
Rodriguez, M. T. T. (2023). Review handbook in clinical chemistry. C & E
Publishing, Inc.
Bishop, M. L., Fody, E. P., Van Siclen, C., Mistler, J. M., & Moy, M. (Eds.).
(2023). Clinical chemistry: Principles, techniques, and correlations (9th
ed.). Jones & Bartlett Learning.
Xu, K. (2023). Electrolytes, interfaces and interphases: Fundamentals and
applications in batteries. Royal Society of Chemistry.
Royal Society of Chemistry. (n.d.). Retrieved from [Link]
[Link]/