ESRD and the sodium potassium pump

[nanari]

I have a problem understanding lab data. My pt has ESRD with an increase potassium and decrease sodium level. I understand that sodium and potassium is inversely related. For those suffering with ESRD, little to no urinary output occurs, which means the body is retaining sodium and potassium . But because patients with renal failure is retaining volume (fluid overload), sodium is less concentrated thus the increase in potassium and the decrease in sodium.

I can't entirely understand the sodium and potassium shift. I've been reading everywhere and it's not connecting.

[Okami_CCRN, BSN, RN]

You are correct that sodium and potassium have an inverse relationship, but in the end-stage renal patient potassium is much more of a concern than sodium. The body will try to compensate for the increase in extracellular sodium by increasing the Na excretion rate per nephron as the GFR decreases. Eventually this compensation will fail in end-stage renal disease and issues of fluid overload will be evident; edema, third-spacing, crackles, etc. Dialysis helps correct this electrolyte abnormality

Remember though that potassium and phosphorus are extremely important in the dialysis/ESRD patient.