Electrolyte & Acid-Base Disorders
Restoring Your Body's Chemical Balance

Electrolytes — including sodium, potassium, calcium, magnesium, phosphorus, and bicarbonate — are charged minerals dissolved in the blood and body fluids that regulate nearly every physiological process in the body, from nerve impulse transmission to heart rhythm, muscle contraction, fluid balance, and bone strength. When these carefully regulated ions fall outside of their narrow normal ranges, the consequences can range from subtle fatigue to life-threatening cardiac arrhythmias or neurological emergencies.

The kidneys are the primary regulators of electrolyte balance in the body, which means that kidney disease frequently causes or worsens electrolyte abnormalities — and conversely, severe electrolyte disorders can themselves damage the kidneys. Nephrologists are uniquely trained to evaluate and treat these conditions because of their deep understanding of renal physiology and its relationship to systemic electrolyte homeostasis.

At AKSNB, our nephrologists evaluate and manage electrolyte disorders in both hospital inpatients requiring urgent intervention and outpatients with chronic electrolyte disturbances requiring long-term management.

Hyponatremia (low sodium): The most common electrolyte disorder in hospitalized patients, hyponatremia can cause confusion, seizures, and death when severe or rapidly corrected. Proper diagnosis requires careful evaluation of volume status and urine electrolytes to differentiate SIADH, cerebral salt wasting, diuretic-induced, and other causes — each requiring different treatment approaches.

Hyperkalemia (high potassium): Dangerous elevations in potassium, common in CKD patients and those on RAAS-blocking medications, can cause fatal cardiac arrhythmias. We manage both acute hyperkalemia emergencies and chronic hyperkalemia requiring dietary adjustment, medication optimization, and newer potassium binders such as patiromer and sodium zirconium cyclosilicate.

Hypercalcemia and hypocalcemia: Abnormal calcium levels arise from parathyroid disorders, malignancy, vitamin D toxicity, or CKD-related mineral bone disease. We systematically evaluate the underlying cause and implement appropriate medical or surgical interventions.

Hypomagnesemia: Often overlooked, low magnesium levels impair the body's ability to correct other electrolyte abnormalities and increase the risk of cardiac arrhythmias. We routinely check and supplement magnesium in patients with refractory hypokalemia or hypocalcemia.

The body maintains blood pH within an extremely narrow normal range (7.35–7.45) through a complex interplay of the lungs, kidneys, and blood buffer systems. When this balance is disturbed, the resulting acidosis or alkalosis can impair enzyme function, alter drug distribution, and threaten organ survival.

The kidneys play the dominant role in regulating the body's acid load over the long term. As CKD progresses, the declining ability to excrete acid leads to metabolic acidosis, which has been shown to accelerate kidney disease progression, increase muscle wasting, and worsen bone loss. We routinely check and treat metabolic acidosis with oral bicarbonate supplementation in our CKD patients.

Our nephrologists are expert at interpreting complex mixed acid-base disorders — particularly in critically ill hospitalized patients — and implementing targeted therapies to correct the underlying problem safely and effectively.