The renal system, meaning kidneys, plays an important role in the regulation of electrolytes. Primary function of the renal system is to filter the blood and remove excess fluid, electrolytes and waste products. When renal function is impaired, the patient is at risk for multiple imbalances.
Renal Failure History
Renal failure can be acute, meaning a sudden onset, or chronic, which is more progressive and longer lasting. Acute renal failure, according to "MEDSURG Nursing," is characterized by a rapid decline in functioning that occurs over days or weeks, resulting in a decrease or cessation of urine production. Chronic renal failure involves progressive and irreversible loss of kidney function.
Symptoms
In acute renal failure, the symptoms occur suddenly, last for a period of time and then resolve with treatment. In chronic renal failure, the imbalances are ongoing and require regular treatment to maintain some stable degree of functioning. In either acute or chronic failure, the patient will have decreased urine output and the urine becomes very concentrated.
Electrolyte Imbalances
When the kidneys fail, the body's mechanism for ridding waste products and excess fluids or electrolytes is impaired. Electrolytes are charged particles that play a role in the function of nerve and muscle activity. Sodium's primary role affects nerve, muscle and fluid management. Potassium is responsible for nerve, muscle and cardiac functioning. Calcium impacts bone structure, nerve, muscle and clotting abilities. Magnesium helps transport sodium and potassium and affects nerve and muscle function. Chloride and phosphate are responsible for acid-base balance in the body. If all of these electrolytes build up, there is a major impact on any system involving nerves and muscles, such as the heart, respiratory system and central nervous system.
Complications
The complications from renal failure and electrolyte imbalance can vary from minor to severe as the levels of electrolytes increase. Mild electrolyte imbalance complications could include muscle weakness, confusion, vomiting or anorexia. Severe imbalances could cause seizures, paralysis of the respiratory system, abnormal heart rhythms or cardiac arrest.
Treatment
Fixing the underlying problem is the primary treatment goal, which is the kidney failure. Acute kidney failure is often caused from kidney stones or a tumor causing a blockage. If the blockage can be removed, kidney function will return. As noted by the Mayo Clinic, chronic kidney failure has no cure, but treatments can help slow the progress of the disease. Patients who have severe end-stage failure may require dialysis or kidney transplant. Once the underlying cause of the renal failure is treated, further management of the electrolyte imbalances is necessary. Management of electrolyte imbalances could include diet modifications, electrolyte supplements or, in some cases, an antidote for the particular electrolyte.
References
- "MEDSURG Nursing"; Update: Diuretic Therapy in Acute Renal Failure- A Clinical Case Study; Warise; May / June 2010
- "Fluids and Electrolytes DeMystified"; McGraw Hill; 2008
- MayoClinic.com: Chronic kidney failure
