Acid-base and electrolyte abnormalities during renal support for acute kidney injury: recognition and management

Blood Purif. 2012;34(2):186-93. doi: 10.1159/000341723. Epub 2012 Oct 24.

Abstract

Acute kidney injury (AKI) is associated with electrolyte and acid-base disturbances such as hyperkalemia, metabolic acidosis, hypocalcemia and hyperphosphatemia. The initiation of dialysis in AKI can efficiently treat these complications. The choice of dialysis modality can be made based on their operational characteristics to tailor the therapy according to the clinical scenario. Each dialysis modality can also trigger significant electrolyte and acid-base disorders, such as hypokalemia, hypophosphatemia and metabolic alkalosis, which may direct changes in fluid delivery and composition. Continuous techniques may be particularly useful in these situations as they allow more time for correction and to maintain balance. This review provides an overview of the electrolyte and acid-base disturbances occurring in AKI and after the initiation of dialysis and discusses therapeutic options in this setting.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Acid-Base Imbalance / etiology*
  • Acid-Base Imbalance / therapy*
  • Acidosis, Respiratory / etiology
  • Acidosis, Respiratory / therapy
  • Acute Kidney Injury / complications*
  • Acute Kidney Injury / therapy*
  • Alkalosis, Respiratory / etiology
  • Alkalosis, Respiratory / therapy
  • Anticoagulants / therapeutic use
  • Citrates / therapeutic use
  • Humans
  • Renal Replacement Therapy / methods*
  • Water-Electrolyte Imbalance / etiology*
  • Water-Electrolyte Imbalance / therapy*

Substances

  • Anticoagulants
  • Citrates