A Personal Problem

A Personal Problem

BLOOD CHEMISTRY
VALUES FOR DIALYSIS PATIENTS

by Patricia Hansen, RN

Patricia Hansen, RN, is Administrator of the

Dialysis Center and Director of Renal Nursing Services at Good Samaritan Hospital of Long

Island, NY.

Blood Chemistry

Normal Values

Accepted Normal for Dialysis Patients

Causes of Abnormals (I.E. of High Abnormals)

Signs and Symptoms Associated with Abnormal Levels

CALCIUM

(Ca)

8.5-10.5

Same

LOW CALCIUM -- eating too many phosphorus foods. Not

taking phosphorus binders. Will go down if phosphorus goes up.

LOW CALCIUM -- muscles twitching and cramping, seizures,

varying degrees of depression, hair loss, cataracts and conjuctivitis.

HIGH CALCIUM -- medications such as Rocaltrol or Calderol may

cause sharp increase if blood not checked regularly.

HIGH CALCIUM -- muscle weakness fatigue, constipa- tion, and

abdominal cramps, nausea, vomiting, loss of apetite. If prolonged, calcification of

blood vessels, including coronary arteries.

PHOSPHORUS

(PO4)

2.5-5.0

Same

Not taking phosphate binders. Eating too many foods

with phosphorus, e.g. milk, cheese, meats, beans.

Calcium deposits in blood vessels, leading to heart and eye

problems. Breaking of bones without specific injury (spontaneous), continuous bone

pain - especially hip, knees and ankles. Causes elevated parathyroid hormone.

MAGNESIUM

1.7-2.3

Same

Elevations due to taking phosphate binders contain-ing

magnesium or other medications, such as Milk of Magnesia or Citrate of Magnesia.

Decreased mental function ranging from drowsiness to insevere

state coma. Decreased tendon reflex leading to paralysis. Nausea and

vomiting. Hypotension due to dilation of blood vessels.

HEMATOCRIT

(Hct)

36-52

Will be

lower- varies with patient. Average is mild 20s.

Decreased production of red blood cells. Blood loss

during or after dialysis.

Fatigue, shortness of breath, chest pain on exertion.

GLUCOSE

80-120

Same

Diabetes, Recently eating very sweet foods

Excessive thirst.

BUN

10-26

Less than 100.

Eating too much protein food.

Fatigue, nausea, insomnia, dry and itching skin. Taste and

smell affected, urine- like body odor and breath.

CO2

Bicarb

21-30

Not less than 12.

Eating too much protein food, creating a more acid blood--

lowering CO2

Slow, shallow breathing.

SODIUM

(Na)

133-150

Same

Eating too much salt, e.g., bacon, potato chips, canned

vegetables.

Edema, elevated blood pressure, shortness of breath, elevated

tempera-

ture, flushed skin color, rapid heartbeat.

CHLORIDE

(Cl)

95-108

Same

Same as Na.

Same as Na.

CREATINE

Below .25

12-28 Varies with muscle mass. Should not change more.

Inadequate dialysis time. Breakdown of muscles (often given

off by muscle after exercise.

POTASSIUM

(K)

3.5-5.4

Same

Eating too many foods with potassium, e.g., green leafy

vegetables, fruit, meat, coffee, and nuts.

Heart stops, vague symptoms-- occasional weakness, numbness,

irregular heartbeat.

ENZYMES

SGOT

10-50

Same

Hepatitis

fatigue.

Pancreatitis

Pericarditis

Nausea, vomiting,

abdominal cramping

Nausea, severe abdominal pain.

Chest pain on inspiration.

GGT

30-115

Same

Hepatitis

Pancreatitis

ALKALINE

PHOSPHATASE

30-115

Same

Not taking phosphate binders

Painful joints. Weakened bones, which could lead to severe

pain and/or deteri- oration requiring surgery.

PARATHYROID

HORMONE

Intact

163-347

C-Terminal

Same

Long-term imbalances of calcium and phosphorus

Same as elevated phosphorus.