Electrolyte Disorders
Electrolytes are minerals that carry an electrical charge and regulate fluid balance, nerve and muscle function, and the body's acid-base balance. When they fall outside the normal range, the consequences can be mild or life-threatening. Electrolyte disorders are among the most common reasons for specialist nephrology referral and one of the areas where specialist input most directly improves outcomes.
Dr Rory McQuillan provides specialist assessment of complex or persistent electrolyte disturbances, with particular expertise in hyponatraemia and other sodium and potassium disorders.
What are electrolytes?
The main electrolytes are sodium, potassium, calcium, phosphate, magnesium, chloride, and bicarbonate. They are tightly regulated by the kidneys and hormones, and their balance is essential for normal cell function. The kidneys are the most important regulator of electrolyte balance, which is why nephrologists are the specialists most often involved when things go wrong.
Common electrolyte disorders
- Hyponatraemia: low sodium, the most common electrolyte disorder
- Hypernatraemia: high sodium
- Hypokalaemia and hyperkalaemia: low or high potassium
- Hypercalcaemia and hypocalcaemia: high or low calcium
- Hypomagnesaemia: low magnesium
- Phosphate disturbances
- Metabolic acidosis and alkalosis
Hyponatraemia in detail
Hyponatraemia is the most common electrolyte disorder seen in clinical practice. It can be caused by medications (especially diuretics, antidepressants, and antiepileptics), heart failure, liver disease, kidney disease, hormone disorders, excessive water intake, or the syndrome of inappropriate antidiuretic hormone secretion (SIADH). Mild cases may be asymptomatic. Severe cases cause confusion, seizures, and coma.
Specialist assessment is important because the cause is often not obvious and the wrong treatment can be more harmful than the original problem.
When to seek specialist input
GP referral to a nephrologist is appropriate for any persistent or unexplained electrolyte disturbance, recurrent hyponatraemia, electrolyte problems associated with medications, suspected SIADH, or electrolyte disturbances in the context of kidney disease. Specialist assessment includes a detailed history and review of medications, focused examination, and targeted investigations to identify the underlying cause.
Investigation and treatment
Investigation typically includes a panel of blood and urine tests, hormone studies where indicated, and review of medications. Treatment is directed at the cause and may include fluid restriction, medication adjustment, supplementation, or treatment of underlying hormonal or kidney conditions. In many cases the disorder resolves once the cause is identified and corrected.
Appointments
Specialist appointments for electrolyte disorders are arranged through GP referral.
Frequently Asked Questions
There are many causes including medications, heart failure, liver disease, kidney disease, hormone problems, and the SIADH syndrome. Specialist assessment identifies which applies to you.
Mild low sodium often causes no symptoms. Severe or rapidly developing low sodium can cause confusion, seizures, and is potentially life-threatening.
Yes. Thiazide diuretics are a common cause of hyponatraemia, particularly in older adults. The medication may need to be adjusted.
Recurrent low potassium often relates to medications (especially diuretics), gastrointestinal losses, or rare hormone conditions. Specialist investigation can find the cause.
Have a Question?
If you’d like more information about Dr. McQuillan’s services or need assistance from the practice team, please get in touch below.
Please note: Appointments are arranged via GP referral.