Electrolytes

This section will cover:

  • Electrolytes’ roles in the body
  • How to measure and interpret electrolyte levels
  • How to connect laboratory results to clinical diagnosis

Biochemical Theory and Pathways

  • Electrolytes: Ions in solution, crucial for fluid balance, nerve/muscle function
  • Key Electrolytes
    • \(Na^+\), \(K^+\), \(Cl^-\), \(HCO_3^-\), \(Ca^{2+}\), \(Mg^{2+}\), \(P\), \(Fe\)
  • Regulation
    • Hormones: Aldosterone, ADH, PTH, Vitamin D
    • Organs: Kidneys, parathyroid glands
  • Transport Mechanisms
    • Ion channels, pumps, binding proteins

Laboratory Test Procedures

  • Common Methods
    • Ion Selective Electrodes (ISE)
    • Spectrophotometry
    • Blood Gas Analysis
  • Key Analytes Measured
    • Electrolyte concentrations in serum, plasma, or whole blood
    • Total Iron-Binding Capacity (TIBC)
  • Important Considerations:
    • Proper specimen collection and handling
    • Reagent and calibration controls

Calculations

  • Osmolality
    • Formula: \(2[Na^+] + \left( \frac {[Glucose (mg/dL)]} {18} \right) + \left( \frac {[BUN (mg/dL)]} {2.8} \right)\)
    • Assesses hydration, presence of toxins
  • Anion Gap
    • Formula: (\(Na^+\) + \(K^+\)) - (\(Cl^-\) + \(HCO_3^-\))
    • Identifies causes of metabolic acidosis

Test Result Interpretation

  • Relate to the patient’s specific information
  • Consider reference ranges
  • Look at patterns and trends
  • What other conditions are indicated or ruled out by these patterns?

Disease State Correlation

  • Key Diseases
    • Hyponatremia, hypernatremia
    • Hypokalemia, hyperkalemia
    • Hypocalcemia, hypercalcemia
    • Hypomagnesemia, hypermagnesemia
    • Hypophosphatemia, hyperphosphatemia
    • Iron Deficiency Anemia, hemochromatosis
    • List may also include cardiac, renal, neurological, etc