Acid-Base and Electrolyte Abnormalities during Renal Support for Acute Kidney Injury: Recognition and Management

Abstract

Acute kidney injury (AKI) is associated with electrolyte and acid-base disturbances such as hyperkalemia, metabolic acidosis, hypocalcemia and hyperphosphatemia. The initiation of dialysis in AKI can efficiently treat these complications. The choice of dialysis modality can be made based on their operational characteristics to tailor the therapy according to the clinical scenario. Each dialysis modality can also trigger significant electrolyte and acid-base disorders, such as hypokalemia, hypophosphatemia and metabolic alkalosis, which may direct changes in fluid delivery and composition. Continuous techniques may be particularly useful in these situations as they allow more time for correction and to maintain balance. This review provides an overview of the electrolyte and acid-base disturbances occurring in AKI and after the initiation of dialysis and discusses therapeutic options in this setting.

Clinical and laboratory parameters associated with acute kidney injury in patients with snakebite envenomation: a prospective observational study from Myanmar

“…Thus, hypocalcemia might be caused by the process of intravascular thrombosis following the occurrence of DIC and rhabdomyolysis, and the occurrence of rhabdomyolysis would result in hyperphosphatemia among patients with snakebite envenomation [35, 36]. However, the possibility that hyperphosphatemia might occur secondary to AKI snake envenoming cannot be excluded [37]. …”

Electrolyte and mineral disturbances in septic acute kidney injury patients undergoing continuous renal replacement therapy

“…Electrolyte, mineral, and acid–base disturbances commonly occur in AKI patients. [ 22 ] Much effort has been made to maintain homeostasis in clinical practice. In particular, CRRT greatly improves the abnormalities of these parameters; however, it can often cause overcorrection, and suboptimal correction remains a concern.…”

Cross-sectional study of the association between functional status and acute kidney injury in geriatric patients

“…On the other hand, patients with CKD and with AKI have several features in common. Both groups have electrolyte imbalances, acidemia, and azotemia, which contribute to appetite loss and malnutrition [ 26 ]. In animal models, AKI can upset the balance of pro-inflammatory and anti-inflammatory cytokines, and lead to systemic inflammation [ 27 ].…”