Elektrolytobalans

Electrolyte balance refers to the proper distribution and concentration of electrically charged minerals in body fluids, including sodium, potassium, chloride, bicarbonate, calcium, magnesium, and phosphate. Electrolytes support fluid homeostasis, nerve conduction, muscle function, and acid–base regulation. The body maintains this balance through intake, losses, and regulation by kidneys and hormones, with rapid shifts possible in illness or injury.

Key ions and roles: Sodium governs extracellular volume and osmolality; potassium is the main intracellular cation essential for membrane potential; chloride and bicarbonate participate in acid–base balance; calcium supports bones, nerves, and muscles; magnesium acts as an enzymatic cofactor; phosphate is central to energy metabolism and signaling.

Regulation and distribution: The kidneys are central to adjusting excretion or reabsorption; hormones such as aldosterone, antidiuretic hormone, and parathyroid hormone modulate intake and bone turnover. Distribution between extracellular and intracellular compartments is influenced by pH, insulin, and osmotic forces. Adequate intake and maintenance of hydration help preserve balance.

Clinical relevance: Disturbances include hyponatremia, hypernatremia, hypokalemia, hyperkalemia, hypocalcemia, hypercalcemia, and magnesium disorders, often with accompanying acid–base abnormalities. Causes include dehydration, vomiting, diarrhea, kidney disease, diuretic use, endocrine disorders, and critical illness. Symptoms range from fatigue and confusion to seizures and cardiac arrhythmias.

Assessment and management: Diagnosis relies on serum electrolytes and, when needed, arterial blood gas analysis and urine studies. Treatment targets the underlying cause and may involve fluid therapy and electrolyte replacement, with careful monitoring to avoid rapid shifts. Prevention emphasizes risk reduction in vulnerable groups and careful medication management.