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Am J Kidney Dis. 2014 Feb;63(2):294-303. doi: 10.1053/j.ajkd.2013.09.017. Epub 2013 Nov 14.

Dysnatremias in patients with kidney disease.

Author information

1
Division of Renal Diseases and Hypertension, University of Colorado, Aurora, CO.
2
Division of Renal Diseases and Hypertension, University of Colorado, Aurora, CO. Electronic address: tomas.berl@ucdenver.edu.

Abstract

Dysnatremias are among the most common electrolyte disorders in clinical medicine. Recent studies have shown that individuals with chronic kidney disease also are afflicted by these electrolyte disorders. Furthermore, their presence imparts an increased risk of mortality. In this review, we discuss studies in experimental animals and in humans that have attempted to establish the mechanisms responsible for limiting urinary dilution and urinary concentration in progressive kidney disease. The clinical implications of these disorders in water excretion are discussed in the setting of optimal water intake as kidney disease progresses. This review emphasizes the management of patients with chronic kidney disease who have marked abnormalities in serum sodium concentrations and gives specific recommendations for modifications in renal replacement therapy prescription in hyponatremic patients with end-stage renal disease.

KEYWORDS:

Hyponatremia; chronic kidney disease; end-stage renal disease; hypernatremia

PMID:
24239050
PMCID:
PMC5325671
DOI:
10.1053/j.ajkd.2013.09.017
[Indexed for MEDLINE]
Free PMC Article

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