12. Mehta RL, Chertow GM, et al. Epidemiology, Trajectories, and Outcomes of Acute Kidney Injury among Hospitalized Patients: A Multicenter Retrospective Cohort Study. medRxiv [Preprint]; 2024.
DOI:
https://doi.org/10.22159/ijms.2026v14i2.58231Keywords:
electrolyte imbalance, chronic renal failure, sepsis, diuretics, vasopressors, sodium, potassium, calcium, chloride, magnesium, bicarbonateAbstract
Electrolyte imbalance is a critical concern in severely ill patients, particularly in patients with chronic renal impairment, sepsis, those on mechanical ventilation, or receiving agents such as diuretics and vasopressin. These conditions can significantly disrupt electrolyte homeostasis and increase the risk of life-threatening complications. Within the intensive care unit setting, disturbances in major electrolytes are among the most frequent metabolic abnormalities encountered and are closely linked to higher morbidity and mortality rates. Electrolyte derangements are not merely reflections of disease severity but can actively exacerbate renal dysfunction, cardiovascular instability, and poor clinical outcomes. Therefore, precise fluid and electrolyte management has become an essential element of individualized pharmacologic care in critical illness. Optimizing electrolyte therapy, ensuring appropriate selection and titration of intravenous fluids, monitoring for drug-induced electrolyte changes, and preventing iatrogenic complications. Acute kidney injury has been reported in patients with either high or low chloride concentrations and increased mortality, while dysnatremia, hypokalemia, and hypocalcemia also carry important prognostic implications. Use of balanced crystalloids can mitigate chloride load, but vigilant monitoring remains necessary to prevent overcorrection and secondary disturbances. In summary, electrolyte management requires an evidence-based and pharmacologically precise approach, with close interprofessional collaboration to safeguard patient outcomes in critical care environments.
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