Blood Mineral and Acid-Base Disorders

Electrolyte Disorders

Electrolyte disorders occur when there is an imbalance in blood levels of sodium , potassium, calcium, magnesium,or phosphorus.  This imbalance can affect your bones, heart, skeletal muscles, intestinal muscles, and nervous system.

We specialize in the diagnosis and treatment of these conditions, whether acute or chronic. 

  • Sodium disorders:  Hyponatremia and hypernatremia
  • Potassium disorders:  Hypokalemia and hyperkalemia
  • Abnormal blood magnesium
  • Blood Calcium disorders
  • Phosphate abnormalities


Hypo and Hypernatremia (sodium disorders)

Hyponatremia is a condition that occurs when the sodium level in the blood is too low. This is due to excessive retention of water by the body. This excess water dilutes the blood sodium and causes low sodium levels. This can be caused by multiple conditions including volume depletion, hormonal abnormalities, lung disease and neurologic disease. The symptoms can range from negligible to life threatening depending on degree and include nausea, headaches, confusion, fatigue,  and seizures.  Hospitalization may be required if the sodium level reduction is extreme. Treatment includes a range of options including fluid restriction, increased sodium intake, and medications.

Hypernatremia is a high blood sodium level due to inadequate blood water relative to sodium.  Causes for this could be medications including diuretics, decreased thirst, poor oral intake, and neurologic conditions. Treatment is aimed at repleting the water in the blood.

All sodium disorders require skill in diagnosis and treatment.  Overly rapid correction can be harmful.

Hypo and Hyperkalemia (potassium disorders)

Hypokalemia is low potassium level in the blood. This is often caused by medications such as diuretics and laxatives, low magnesium,  diarrhea, or insufficient intake of dietary potassium.   Symptoms of hypokalemia include constipation, palpitations, fatigue, muscle weakness, and tingling or numbness. Low potassium can affect the heart rhythm, and when it is very low can result in cardiac arrhythmias.

Hyperkalemia is often seen in chronic kidney disease and can be related to medication use and certain hormonal disorders.  Pumping or squeezing the fist during the blood drawing process can cause an artefactual increase in blood potassium levels. Symptoms of hyperkalemia include muscle fatigue, weakness and cardiac arrhythmias.  It can be controlled with dietary modifications, medications, and dialysis.  When severe, hospitalization is required as very high values can cause life threatening cardiac abnormalities.  Foods that are high in potassium include citrus fruit, bananas, potatoes, tomatoes, and melons.  

Magnesium disorders

 Abnormal blood magnesium levels can effect the heart, muscles and nervous system.  Disorders of blood magnesium can be caused by inadequate nutritional intake, alcohol use, vomiting, diarrhea, diabetes mellitus, diuretics, intestinal malabsorption syndromes,  and inflammatory bowel disease with chronic diarrhea.  Oral and intravenous magnesium repletion or a combination of the two is indicated for a low magnesium level.  

Hypercalcemia (high blood calcium)

Hypercalcemia (high blood calcium) is a common clinical problem.  It is often caused by overactive production of parathyroid hormone by the parathyroid gland.  This condition is known as primary hyperparathyroidism.  Hypercalcemia can cause kidney stones, fatigue, weakness, depression,  memory impairment, and bone disease.  If symptomatic, surgery on the parathyroid gland may be necessary. Sometimes, in mild asymptomatic cases the calcium level and symptoms are simply monitored.  Other causes of hypercalcemia include malignancy, vitamin D intoxication, and medications. 

Acid-Based Disorders

Excessive or inadequate blood acid levels can result in metabolic dysfunction with cardiac, respiratory, skeletal and kidney consequences. These disorders can result from multiple conditions and medications but are commonly seen in a variety of kidney conditions including chronic kidney disease. Identification and treatment is essential to maintaining stable kidney functions and overall health.