Critical Care Medicine-Renal, Electrolyte and Acid Base Disorders>>>>>Diagnosis and Monitoring in Renal Failure
Question 3#

Which of the electrolyte abnormalities is associated with advanced chronic kidney disease?

A. Hyponatremia
B. Hypophosphatemia
C. Hypomagnesemia
D. Hypokalemia

Correct Answer is A


Correct Answer: A

Kidneys play an essential role in the body to maintain normal acid-base status and electrolyte levels. In addition, kidneys excrete acids in the form of ammonium chloride. As kidney disease progresses, patients lose the ability to effectively neutralize and excrete acids, leading to metabolic acidosis. As the glomerular filtration decreases, renal failure patients lose the ability to concentrate urine, which can lead to hyponatremia. Studies suggest that a decreased clearance of vasopressin also contributes to the development of dysnatremia. It is not uncommon for hyperkalemia, hyperphosphatemia, and hypermagnesemia to occur as the kidneys lose their ability to excrete these electrolytes.

References :

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  2. Cadnapaphornchai MA, Schrier RW.“Pathogenesis and management of hyponatremia.” Am J Med. 2000;109(8):688-692.
  3. Dhondup T, Qian Q. “Electrolyte and acid-base disorders in chronic kidney disease and end-stage kidney failure.” Blood Purif. 2017;43(1– 3):179-188. doi:10.1159/000452725. Epub 2017 January 24.