Medicines to Control Electrolyte Imbalances

Treating electrolyte imbalances caused by kidney failure can be difficult, because many medicines lower some electrolyte levels while raising other levels. Your doctor may need to regularly monitor your electrolyte levels.

Potassium

Severe chronic kidney disease and kidney failure can increase potassium levels above the normal range (hyperkalemia). Medicines used to lower potassium levels may include:

• Potassium binders, such as sodium polystyrene sulfonate (Kayexalate).
• Diuretics, which increase the amount of potassium released by the kidneys through the urine. This may be an option if you have some remaining kidney function.

Hemodialysis is the best way to lower potassium levels if kidney failure has developed rapidly and potassium levels are very high.

Calcium and phosphorus

Kidney failure causes an increased breakdown of bone and abnormal metabolism of calcium , phosphorus , vitamin D , and parathyroid hormone (PTH) . This often leads to a bone disease called renal osteodystrophy. Medicines used to restore proper metabolism of these chemicals may include:

• Calcium-containing phosphate binders, such as calcium acetate and calcium carbonate. They are used to raise levels of calcium and lower levels of phosphorus in the bloodstream. Phosphate binders that contain aluminum should be avoided, to prevent aluminum poisoning.
• Non-calcium phosphate binders, which are calcium- and aluminum-free. Examples are sevelamer and lanthanum. They are also used to control serum phosphate and reduce PTH levels.
• Vitamin D3, which may increase calcium levels and help store excess phosphate in bone. While taking vitamin D3, you will be watched closely for hypercalcemia .