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Electrolytes

  • Medical Author: Melissa Conrad Stöppler, MD
  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR

What are electrolytes?

Chemically, electrolytes are substances that become ions in solution and acquire the capacity to conduct electricity. Electrolytes are present in the human body, and the balance of the electrolytes in our bodies is essential for normal function of our cells and our organs.

Common electrolytes that are measured by doctors with blood testing include sodium, potassium, chloride, and bicarbonate. The functions and normal range values for these electrolytes are described below.

Sodium

Sodium is the major positive ion (cation) in fluid outside of cells. The chemical notation for sodium is Na+. When combined with chloride, the resulting substance is table salt. Excess sodium (such as that obtained from dietary sources) is excreted in the urine. Sodium regulates the total amount of water in the body and the transmission of sodium into and out of individual cells also plays a role in critical body functions. Many processes in the body, especially in the brain, nervous system, and muscles, require electrical signals for communication. The movement of sodium is critical in the generation of these electrical signals. Therefore, too much or too little sodium can cause cells to malfunction, and extremes in the blood sodium levels (too much or too little) can be fatal.

  • Increased sodium (hypernatremia) in the blood occurs whenever there is excess sodium in relation to water. There are numerous causes of hypernatremia; these may include kidney disease, too little water intake, and loss of water due to diarrhea and/or vomiting.
  • A decreased concentration of sodium (hyponatremia) occurs whenever there is a relative increase in the amount of body water relative to sodium. This happens with some diseases of the liver and kidney, in patients with congestive heart failure, in burn victims, and in numerous other conditions.

A Normal blood sodium level is 135 - 145 milliEquivalents/liter (mEq/L), or in international units, 135 - 145 millimoles/liter (mmol/L).

Potassium

Potassium is the major positive ion (cation) found inside of cells. The chemical notation for potassium is K+. The proper level of potassium is essential for normal cell function. Among the many functions of potassium in the body are regulation of the heartbeat and the function of the muscles. A seriously abnormal increase in potassium (hyperkalemia) or decrease in potassium (hypokalemia) can profoundly affect the nervous system and increases the chance of irregular heartbeats (arrhythmias), which, when extreme, can be fatal.

  • Increased potassium is known as hyperkalemia. Potassium is normally excreted by the kidneys, so disorders that decrease the function of the kidneys can result in hyperkalemia. Certain medications may also predispose an individual to hyperkalemia.
  • Hypokalemia, or decreased potassium, can arise due to kidney diseases; excessive losses due to heavy sweating, vomiting, diarrhea, eating disorders, certain medications, or other causes.

The normal blood potassium level is 3.5 - 5.0 milliEquivalents/liter (mEq/L), or in international units, 3.5 - 5.0 millimoles/liter (mmol/L).

Chloride

Chloride is the major anion (negatively charged ion) found in the fluid outside of cells and in the blood. An anion is the negatively charged part of certain substances such as table salt (sodium chloride or NaCl) when dissolved in liquid. Chloride plays a role in helping the body maintain a normal balance of fluids.

The balance of chloride ion (Cl-) is closely regulated by the body. Significant increases or decreases in chloride can have deleterious or even fatal consequences:

  • Increased chloride (hyperchloremia): Elevations in chloride may be seen in diarrhea, certain kidney diseases, and sometimes in overactivity of the parathyroid glands.
  • Decreased chloride (hypochloremia): Chloride is normally lost in the urine, sweat, and stomach secretions. Excessive loss can occur from heavy sweating, vomiting, and adrenal gland and kidney disease.

The normal serum range for chloride is 98 - 108 mmol/L.

Bicarbonate

The bicarbonate ion acts as a buffer to maintain the normal levels of acidity (pH) in blood and other fluids in the body. Bicarbonate levels are measured to monitor the acidity of the blood and body fluids. The acidity is affected by foods or medications that we ingest and the function of the kidneys and lungs. The chemical notation for bicarbonate on most lab reports is HCO3- or represented as the concentration of carbon dioxide (CO2). The normal serum range for bicarbonate is 22-30 mmol/L.

The bicarbonate test is usually performed along with tests for other blood electrolytes. Disruptions in the normal bicarbonate level may be due to diseases that interfere with respiratory function, kidney diseases, metabolic conditions, or other causes.

Reviewed on 6/7/2018

Medically reviewed by Joseph T. Palermo, DO; Board Certified Internal Medicine/Geriatric Medicine

REFERENCE:

"Maintenance and replacement fluid therapy in adults"
uptodate.com

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