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But any changes in the ECF can have an indirect impact on the composition of intracellular fluid. Electrolyte can be defined as substances that acquire an electrical charge when dissolved in water (Mehtheny 2000). Majority of the body electrolytes include sodium, potassium, calcium chloride and bicarbonate. Each of these electrolytes exhibit different chemical properties. Some of these electrolytes such as sodium, potassium and calcium attain positive charge whereas the latter two electrolytes have a negative charge on them.
This is crucial in identifying their properties and calculating anion gaps discussed later. Each of these electrolytes has their unique functions and any changes in their normal concentration in the body fluids can have a significant effect on the functions of different organs of the body. There is some difference in the concentration of different electrolytes in ECF and ICF. The major electrolytes present in the ECF include sodium and chloride. ICF on the other side has potassium as its major electrolyte.
Hyperkalemia: Hyperkalemia is a state where plasma concentration of potassium ions exceeds the normal upper limit of 5.0 mmol/L. As mentioned earlier potassium is a major cation of the intra cellular fluid. The normal range of extracellular concentration of potassium is about 3.5-5.0 mmol/L whereas the intracellular concentration may rise upto150mmol/L (Braunwald et al 2008). Potassium is mostly contained within the cells so that it does not have any effect on the outside fluids. But any pathological conditions whereby cell destruction causes the leakage of potassium ions into the ECF may cause hyperkalemia (Schrier 2003).
This phenomenon is known as cellular redistribution. Disease conditions such as rhabdomyolysis, trauma and hypothermia are few examples that compromise the ability of the cell to withhold potassium within its membranes. Other causes of hyperkalemia include drug induced hyperkalemia and renal failure. Succinylcholine and Thalidomide are more common drugs that are known to cause hyperkalemia. Decrease renal excretion of potassium as a result of renal failure is also known to raise the potassium levels in the blood.
Excess dietary intake of potassium is rarely a cause for hyperkalemia due to body’s adaptive mechanism known as potassium adaptation whereby excess is efficiently excreted by the kidneys and other mechanisms. This increase in the potassium levels clinically manifest in the excitable tissues. Therefore, paresthesias and muscular fasciculation of both limbs are the earlier manifestation of hyperkalemia. It is due to increase duration of polarization as a result of excessive potassium ions partially depolarizing the cell membranes.
Heart is arguably the most important organ affected by the disturbance in potassium concentration. Cardiac toxicity of potassium can be evident on the ECG in the form of elevated or peaked T wave (Schrier 2003). Other important impact of hyperkalemia is on the kidneys where it inhibits the reabsorption of NH4+ contributing to metabolic acidosis which further exacerbates hyperkalemia by redistributing the potassium ions out of the cells (Braunwald 2008). Hypercalcemia: Calcium is an important electrolyte that is required in many signaling pathways of neurons.
It is also an important constituent of bones and is essential for their strength. There are many other crucial roles that are played by calcium so it is
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