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The most common electrolytic abnormalities among PD patients are hyper and hypokalemia, hypermagnesemia and hypernatremia.
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. 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 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 disease1.
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 (see PD Solution Formulation).
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References:
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Navarro JF, Mora C, Garcia J, Macia M, Gallego E, Chahin J, Mendez ML, Rivero A. Hypermagnesemia in CAPD. Relationship with parathyroid hormone levels. Perit Dial Int 18:77-80, 1998