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Last updated: 11/24/2009
Electrolyte concentrations are similar whether measured in serum or plasma. Values are expressed as mmol/L for sodium, potassium, chloride, and bicarbonate. Magnesium results are often reported as milliequivalents per liter (meq/L) or in mg/dL. Total...
calcium is usually reported in mg/dL and ionized calcium in mmol/L. Since severe electrolyte disturbances can be associated with life-threatening consequences such as heart failure, shock, coma, or tetany, alert values are used to warn physicians of impending crisis. Typical reference ranges and alert values are cited below:
- serum or plasma sodium: 135โ145 mmol/l; alert levels: less than 120 mmol/l and greater than 160 mmol/l
- serum potassium: 3.6โ5.4 mmol/l (plasma, 3.6โ5.0 mmol/l); alert levels: less than 3.0 mmol/l and greater than 6.0 mmol/l
- serum or plasma chloride: 98โ108 mmol/l
- sweat chloride: 4โ60 mmol/l
- serum or plasma bicarbonate: 18โ24 mmol/l (as total carbon dioxide, 22โ26 mmol/l); alert levels: less than 10 mmol/l and greater than 40 mmol/l
- serum calcium: 8.5โ10.5 mg/dl (2.0โ2.5 mmol/l); alert levels: less than 6.0 mg/dl and greater than 13.0 mg/dl
- ionized calcium: 1.0โ1.3 mmol/l
- serum inorganic phosphorus: 2.3โ4.7 mg/dl (children, 4.0โ7.0 mg/dl); alert level: less than 1.0 mg/dl
- serum magnesium: 1.8โ3.0 mg/dl (1.2โ2.0 meq/l or 0.5โ1.0 mmol/l)
- ionized magnesium: 0.53โ0.67 mmol/l
- osmolality (calculated) 280โ300 mosm/kg
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Tests that measure the concentration of electrolytes are useful in the emergency room and to obtain clues for the diagnosis of specific diseases. Electrolyte tests are used for diagnosing dietary deficiencies, excess loss of nutrients due to urination, vomiting, and diarrhea, or abnormal shifts in the location of an electrolyte within the body. When an abnormal electrolyte value is detected, the physician may either act to immediately correct the imbalance directly (in the case of an emergency) or run further tests to determine the underlying cause of the abnormal electrolyte value. Electrolyte disturbances can occur with malfunctioning of the kidney (renal failure), infections that produce severe and continual diarrhea or vomiting, drugs that cause loss of electrolytes in the urine (diuretics), poisoning due to accidental consumption of electrolytes, or diseases involving hormones that regulate electrolyte concentrations.
Electrolyte tests are typically conducted on blood plasma or serum, urine, and diarrheal fluids. Electrolytes can be classified in at least five different ways. One way is that some electrolytes tend to exist mostly inside cells, or are intracellular, while others tend to be outside cells, or are extracellular. Potassium, phosphate, and magnesium occur at much greater levels inside the cell than outside, while sodium and chloride occur at much greater levels extracellularly. A second classification distinguishes those electrolytes that participate directly in the transmission of nerve impulses and those that do not. Sodium, potassium, and calcium are the important electrolytes involved in nerve impulses, and disorders affecting them are most closely associated with neurological disorders. A third classification focuses on electrolytes that are able to form a tight union, or complex, with one another. Calcium and phosphate have the greatest tendency to form complexes with each other. Disorders that cause an increase in either plasma calcium or phosphate can result in the deposit of calcium-phosphate crystals in the soft tissues of the body. A fourth classification concerns those electrolytes that influence the acidity or alkalinity of the bloodstream, also known as the pH. The pH of the bloodstream is normally in the range of 7.35-7.45. A decrease below this range is called acidosis, while a pH above this range is called alkalosis. The electrolytes most closely associated with the pH of the bloodstream are bicarbonate, chloride, and phosphate.
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In 2000, the estimated number of doctor visits and outpatient hospital visits by patients aged 20 or older with UTI or cystitis listed as a diagnosis was of 8.27 million visits (1.41 million men; 6.86 million women) with UTI as the primary diagnosis.
From: NKUDIC
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