Importance of healthy kidney function is to maintain a balance of Potassium, Phosphorous and calcium and Vitamin D. Chronic kidney disease (CKD) affects every body function, including or through mineral imbalance in body.
Read below an extract from “Chronic Kidney Care” by Sharon Broscious and Judith Castognola, critical care nurses or you may want to click here to read it in detail in the original journal article. Why are more people presenting with sickened kidneys?
Multiple electrolyte levels are altered in patients with CKD. Potassium levels may be normal until late in ESRD, and elevated potassium levels are often associated with CKD because of the inability of the kidney to excrete potassium as a result of decreased GFR. In addition, when metabolic acidosis is present, potassium ions shift from the intracellular compartment to the extracellular space in exchange for H+, in an effort to maintain extra-cellular acid-base balance. The kidneys normally excrete 40 to 60 mmol of potassium daily.11 J.M.’s potassium level was 5.8 mmol/L, increasing his risk for fatal dysrhythmias.
Serum phosphorus and calcium levels are also altered in CKD. When GFR is less than 30 to 50 mL/min per 1.73 m2, phosphorus excretion is impaired.10 Because of the reciprocal relationship between phosphorus and calcium, this increased retention of phosphorus results in a decrease in the serum level of calcium. Three additional mechanisms can affect calcium level. Calcium is found in 3 forms in the blood: attached to protein, attached to other complexes, and free or ionized. Because some calcium is bound to protein, total serum calcium level can decrease when albumin level decreases. J.M. had proteinuria. This loss of albumin can contribute to a decreased serum level of calcium. CKD also has an effect on vitamin D synthesis. The kidneys normally convert inactive vitamin D to its active form: 1,25-dihydroxycholecalciferol.11 Impaired vitamin D synthesis results in decreased absorption of calcium in the gastrointestinal tract. The third mechanism that affects serum levels of calcium is the endocrine system. When the serum level of calcium decreases, the parathyroid gland increases its secretion of parathyroid hormone, causing calcium to be released from the bone and compensating for the decreased serum level of calcium.12 Results of J.M.’s laboratory tests showed a calcium level of 2.05 mmol/L (8.2 mg/dL) and a phosphorus level of 3.91 mmol/L (12.1 mg/dL), indicating impaired phosphorus excretion and a reciprocal decrease in calcium level.
To read more click here. You may want to continue reading to learn about:
how the healthy and diseased kidneys balance electrolytes;
the increasing public health care costs to take care of increasing number of individuals with failind kidneys;
the role of parathyroid hormone in maintaining electrolyte balance;
the alterations in excretory functions
how anemia results from chronic kidney disease
how chronic kidney disease affects every body function
Chronic Kidney Disease
Acute Manifestations and Role of Critical Care Nurses
Sharon K. Broscious, RN, DSN, CCRN and Judith Castagnola, RN, MSN
+ Author Affiliations
Sharon K. Broscious is an associate professor in the School of Nursing at Troy University, Atlantic Region, in Norfolk, Va.
Judith Castagnola is a facility administrator at DaVita Peninsula Dialysis in Newport News, Va.
Corresponding author: Sharon K. Broscious, Troy University, Atlantic Region, 5425 Robin Hood Rd, Ste B1, Norfolk, VA 23513.
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