Case scenarios

Abdel, 75, has end-stage chronic kidney disease (eGFR 10 mL/min) secondary to poorly controlled type 2 diabetes. He is currently prescribed calcium 2 tablets twice daily with food, calcitriol 0.25 mcg twice a week, perindopril 5 mg daily, sodium bicarbonate capsule 840 mg daily, furosemide 250 mg daily and insulin aspart + insulin aspart protamine
20 units twice daily. He informs you that he has been told he will likely need dialysis in the coming months. You are reviewing Abdel’s medicines and note that his total calcium levels are low at 1.9 mmol/L.

Learning Objectives

After reading this article, pharmacists should be able to:

  • Describe the effects of sodium and calcium concentration disturbances
  • List causes of sodium and calcium concentration disturbances 
  • Discuss how sodium and calcium concentration disturbances are treated.

Competency standards (2016) addressed: 1.1, 1.3, 1.4, 1.5, 3.1, 3.2, 3.3, 3.5

Accreditation number: CAP2407AMCS

Accreditation expiry: 30/06/2027

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Introduction

Electrolytes, including potassium, magnesium, sodium and calcium, are essential to the functioning of the human body. The significance of potassium and magnesium is covered in the first part of this two-part series, Electroly

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