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Disturbance of water-electrolyte balance

Medical expert of the article

Endocrinologist
, medical expert
Last reviewed: 04.07.2025

Violation of water-electrolyte balance in the body occurs in the following situations:

  • With hyperhydration - excessive accumulation of water in the body and its slow release. The liquid medium begins to accumulate in the intercellular space and because of this its level inside the cell begins to increase, and it swells. If hyperhydration involves nerve cells, then convulsions occur and nerve centers are excited.
  • With dehydration - lack of moisture or dehydration, the blood begins to thicken, due to viscosity, blood clots form and blood flow to tissues and organs is disrupted. With its deficiency in the body over 20% of body weight, death occurs.

It manifests itself by weight loss, dry skin, cornea. At a high level of deficiency, the skin can be gathered into folds, the subcutaneous fat tissue is similar in consistency to dough, the eyes are sunken. The percentage of circulating blood also decreases, this is manifested in the following symptoms:

  • facial features become more defined;
  • cyanosis of the lips and nail plates;
  • hands and feet are cold;
  • blood pressure drops, pulse is weak and rapid;
  • renal hypofunction, high levels of nitrogenous bases as a result of protein metabolism disorders;
  • disruption of the heart, respiratory depression (according to Kussmaul), vomiting is possible.

Isotonic dehydration is often recorded - water and sodium are lost in equal proportions. This condition is common in acute poisoning - the necessary volume of liquid medium and electrolytes is lost during vomiting and diarrhea.

Causes of water-electrolyte imbalance

The causes of water-electrolyte imbalance are redistribution of body fluids and external fluid loss.

Reasons for decreased calcium levels in the blood:

  • thyroid damage;
  • treatment with radioactive iodine preparations;
  • thyroid removal;
  • in pseudohypoparathyroidism.

Reasons for reducing sodium:

  • long-term severe illnesses with decreased urine output;
  • conditions in the postoperative period;
  • self-medication and uncontrolled use of diuretics.

Reasons for decreased potassium:

  • intracellular movement of potassium;
  • confirmation of alkalosis;
  • presence of aldosteronism;
  • use of corticosteroid drugs.
  • alcohol abuse;
  • liver pathologies;
  • small bowel surgery;
  • insulin injections;
  • hypothyroidism.

Reasons for increased potassium levels:

  • increase in cations and retention of potassium compounds;
  • damage to cells and the release of potassium from them.

Symptoms of water-electrolyte imbalance

The first symptoms of water-electrolyte imbalance depend on what pathological process is occurring in the body (hydration, dehydration). These include increased thirst, swelling, vomiting, and diarrhea. Often, there is an altered acid-base balance, low blood pressure, and an irregular heartbeat. These signs should not be ignored, as they lead to cardiac arrest and death if medical assistance is not provided in time.

With a lack of calcium in the blood, smooth muscle spasms appear, especially dangerous is spasm of the larynx and large vessels. With an increase in the content of Ca - pain in the stomach, a feeling of thirst, vomiting, increased urination, inhibition of blood circulation.

Deficiency of K manifests itself as atony, alkalosis, chronic renal failure, brain pathologies, intestinal obstruction, ventricular fibrillation and other changes in heart rhythm. Increased potassium content manifests itself as ascending paralysis, nausea, vomiting. The danger of this condition is that ventricular fibrillation and atrial arrest quickly develop.

High Mg in the blood occurs with renal dysfunction, abuse of antacids. Nausea, vomiting, fever, and slow heart rate appear.

Symptoms of water-electrolyte imbalance indicate that the described conditions require immediate medical attention to avoid even more serious complications and death.

Diagnosis of water-electrolyte imbalance

Diagnosis of water-electrolyte imbalance upon initial admission is carried out approximately, further treatment depends on the body's response to the introduction of electrolytes, anti-shock drugs (depending on the severity of the condition).

The necessary information about a person and his state of health upon hospitalization is established:

  • By anamnesis. During the survey (if the patient is conscious), data on existing water-salt metabolism disorders are clarified (peptic ulcer, diarrhea, pyloric stenosis, some forms of ulcerative colitis, severe intestinal infections, dehydration of other etiologies, ascites, low-salt diet).
  • Determining the degree of exacerbation of the current disease and further measures to eliminate complications.
  • General, serological and bacteriological blood tests to identify and confirm the underlying cause of the current pathological condition. Additional instrumental and laboratory tests are also prescribed to clarify the cause of the malaise.

Timely diagnosis of water-electrolyte imbalance makes it possible to identify the severity of the disorder as soon as possible and promptly organize appropriate treatment.

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Treatment of water-electrolyte imbalance

Treatment of water-electrolyte imbalance should be carried out according to the following scheme:

  • To eliminate the possibility of progressive development of a life-threatening condition:
    • bleeding, acute blood loss;
    • eliminate hypovolemia;
    • eliminate hyper- or hypokalemia.
  • Restore normal water-salt metabolism. The following medications are most often prescribed to normalize water-salt metabolism: 0.9% NaCl, 5%, 10%, 20%, 40% glucose solution, polyionic solutions (Ringer-Locke solution, lactasol, Hartman solution, etc.), erythrocyte mass, polyglucin, 4% soda, 4% KCl, 10% CaCl2, 25% MgSO4, etc.
  • To prevent possible iatrogenic complications (epilepsy, heart failure, especially when administering sodium preparations).
  • If necessary, carry out diet therapy in parallel with intravenous administration of medications.
  • When administering saline solutions intravenously, it is necessary to monitor the level of VSO, acid-base balance, control hemodynamics, and monitor renal function.

An important point is that before starting the intravenous administration of saline components, it is necessary to calculate the probable fluid loss and draw up a plan for restoring normal IVO. The loss is calculated using the formulas: •

Water (mmol) = 0.6 x Weight (kg) x (140/Na true (mmol/L) + glucose/2 (mmol/L)),

Where 0.6 x Weight (kg) is the amount of water in the body

140 – average % Na (normal)

Na ist – true concentration of sodium.

Water deficit (l) = (Htist – HtN): (100 - HtN) x 0.2 x Weight (kg),

Where 0.2 x Weight (kg) is the volume of extracellular fluid

HtN = 40 for females, 43 for males.

  • Electrolyte content - 0.2 x Weight x (Norm (mmol/l) – True content (mmol/l).

Prevention of water-electrolyte imbalance

Prevention of water-electrolyte imbalance consists of maintaining normal water-salt balance. Salt metabolism can be disturbed not only in severe pathologies (3-4 degree burns, gastric ulcer, ulcerative colitis, acute blood loss, food poisoning, infectious diseases of the gastrointestinal tract, mental disorders accompanied by eating disorders - bulimia, anorexia, etc.), but also with excessive sweating accompanied by overheating, systematic uncontrolled use of diuretics, prolonged salt-free diet.

For preventive purposes, it is worth monitoring your health, controlling the course of existing diseases that can provoke a salt imbalance, not prescribing medications that affect fluid transit, replenishing the necessary daily fluid intake under conditions close to dehydration, and eating properly and in a balanced manner.

Prevention of water-electrolyte imbalance also lies in a proper diet - eating oatmeal, bananas, chicken breast, carrots, nuts, dried apricots, figs, grape and orange juice is not only healthy in itself, but also helps maintain the correct balance of salts and microelements.

Prognosis of water-electrolyte imbalance

The prognosis for water-electrolyte imbalance is favorable if the underlying cause is stopped and eliminated in a timely manner. If treatment is not followed or help is not sought in a timely manner, life-threatening conditions may develop, as well as:

  • with hyperhydration, tonic convulsions, suffocation, swelling of soft tissues, cerebral and pulmonary edema appear;
  • decreased potassium levels, decreased percentage of sodium in the bloodstream, which affects blood viscosity and its fluidity;
  • the cornea and skin dry out. If the fluid deficiency exceeds 20% of the body weight, death occurs;
  • due to changes in blood aggregation, arrhythmia develops and cardiac arrest is possible;
  • depression of respiratory function, disruption or cessation of blood circulation.
  • With hyperhydration, tonic convulsions and suffocation appear.

Also, water-salt imbalance often develops in those who have been on a salt-free diet for a long time or drink little liquid in the heat and during high physical activity. In such cases, it is very useful to drink 1-1.5 liters of mineral water per day - to maintain an optimal salt balance. In this case, the prognosis for water-electrolyte imbalance in the future will be positive.

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