TableĀ 1:

Causes of electrolyte and glucose disturbances in patients in intensive care units

ConditionCause*
HypernatraemiaVomiting and/or diarrhoea
Burns
Diuretic use
Renal disease
Diabetes insipidus (central or renal)
Lack of access to water
Primary hypodipsia
Administration of high sodium fluids (eg, hypertonic saline, total parenteral nutrition)
Hyperaldosteronism (Conn's syndrome)
HyponatraemiaVomiting and/or diarrhoea
Abdominal/pleural fluid
Burns
Hypoadrenocorticism (Addison's disease)
Administration of low sodium fluids (eg, 5 per cent dextrose, 0.18 per cent sodium chloride)
Congestive heart disease
Liver failure
Renal disease
Syndrome of inappropriate antidiuretic hormone secretion
HyperkalaemiaAnuric/oliguric acute kidney injury
Urethral obstruction
Uroabdomen
Hypoadrenocorticism (Addison's disease)
Repeated drainage of chylothorax
Intestinal parasites
Tissue necrosis
HypokalaemiaLow potassium-containing fluid administration (eg, Hartmann's solution, 0.9 per cent sodium chloride)
Anorexia
Chronic kidney disease (CKD)
Vomiting and/or diarrhoea
Hyperaldosteronism (Conn's syndrome)
Diuretic use
Insulin administration
HypercalcaemiaNeoplasia (lymphoma, anal gland adenocarcinoma)
Vitamin D intoxication
CKD
Acute kidney injury
Idiopathic (cats)
Granulomatous disease (including angiostrongylosis)
Hypoadrenocorticism (Addison's disease)
Hyperthyroidism
HypocalcaemiaCritical illness
Pancreatitis
Hypoparathyroidism
CKD
Puerperal tetany
Hypoproteinaemia can result in a low total calcium level
HypoglycaemiaSepsis
Hypoadrenocorticism (Addison's disease)
Neonatal patient with immature hepatic function
Xylitol toxicity
Insulin overdose
Insulinoma
Hepatic failure
  • * Common causes are given in bold