Managing fluid and electrolyte disorders in renal failure

Because of the role of the kidneys in maintaining homeostasis in the body, kidney failure leads to derangements of fluid, electrolyte, and acid-base balance. The most effective therapy of a uremic crisis is careful management of fluid balance, which involves thoughtful assessment of hydration, a fluid treatment plan personalized for the specific patient, repeated and frequent reassessment of fluid and electrolyte balance, and appropriate changes in the treatment plan in response to the rapidly changing clinical situation of the patient that has renal failure. Disorders of sodium, chloride, potassium, calcium, and phosphorus are commonly encountered in renal failure and may be life threatening. Treatment of metabolic acidosis and nutritional support are frequently needed.