Orris

Disorders of water and electrolyte balance

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“Disorders of water and electrolyte balance” is a broad topic. It can be organized as:
  1. Water balance disorders
    • Dehydration and volume depletion
    • Water excess and edema
    • Diabetes insipidus
    • Syndrome of inappropriate ADH secretion (SIADH)
  2. Sodium disorders
    • Hyponatremia
    • Hypernatremia
    • Assessment of serum osmolality, urine osmolality, and volume status
    • Safe correction and neurologic complications
  3. Potassium disorders
    • Hypokalemia
    • Hyperkalemia
    • ECG changes, causes, and emergency treatment principles
  4. Calcium disorders
    • Hypocalcemia
    • Hypercalcemia
    • Tetany, renal stones, bone disease, and cardiac effects
  5. Magnesium and phosphate disorders
    • Hypomagnesemia and hypermagnesemia
    • Hypophosphatemia and hyperphosphatemia
  6. Acid-base balance
    • Metabolic acidosis and alkalosis
    • Respiratory acidosis and alkalosis
    • Arterial blood gas interpretation and anion gap
These disorders arise when intake, losses, renal regulation, hormones, or distribution between body compartments are abnormal. A practical approach is to first assess urgency, hydration and extracellular-fluid status, serum electrolytes and osmolality, renal function, and ECG when potassium or calcium abnormalities are possible.
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