Disturbances in many electrolyte concentrations in peritoneal dialysis patients may occur. However, the most common are those related to potassium, magnesium, and sodium(1,2).

Hyper- and Hypokalemia

Hyperkalemia generally results from excessive dietary intake and insufficient dialysis. Hypokalemia is due to poor nutritional intake; excessive losses, either through vomiting or diarrhea or excessive dialysate losses; or from increased cellular uptake(1,2). The most common symptoms include mild or severe weakness and cardiac arrhythmias. Approximately 30% of PD patients require oral or IP potassium supplementation or are encouraged to increase their dietary intake.

Hypermagnesemia

Hypermagnesemia is a common finding in CAPD patients particularly among those ingesting magnesium containing phosphate binders, antacids or laxatives. Hypermagnesemia suppresses PTH levels contributing to adynamic bone disease(3).

Hypernatremia

Hypernatremia can result from high ultrafiltration and the repeated use of hypertonic PDF due to excessive removal of water and retention of sodium due to sieving(2).

References

1. Holley JL, Schmidt RJ. Noninfectious complications of continuous peritoneal dialysis. Golper TA, ed. UpToDate. 2016. Available from: https://www.uptodate.com/contents/noninfectious-complications-of-continuo….
2. Bargman JM. Noninfectious Complications of Peritoneal Dialysis. In: Khanna R, Krediet RT, eds. Nolph and Gokal’s Textbook of Peritoneal Dialysis. Third. New York: Springer; 2009:571-609.
3. Navarro JF, Mora C, García J, Macía M, Gallego E, Chahin J, Méndez ML, Rivero A. Hypermagnesemia in CAPD. Relationship with parathyroid hormone levels. Perit Dial Int. 1998;18(1):77-80. Available from: https://www.ncbi.nlm.nih.gov/pubmed/9527035.

P/N 102498-01 Rev. A 06/2016