Low sodium levels /electrolytes out of kilter

[violetqueen]

Does anyone have any experience or advice on this subject ?
My 90 year old mum currently has falling sodium levels and rising pottasium .
She'll probably have to go into hospital tommorrow for IV .
Withdrawal of her diuertic,and blood pressure medication for 12 days so far ,haven't helped .
GP is thinking failing kidneys .
No chance she could stay at home on a drip and have regular blood tests is there ?
Or is that madness .
I realise that this is a serious situation - its just that I think this isn't new for her and that as her health fluctuates from day to day that maybe her levels are as well .
Also realise that very complex ,so this post bit of a long shot ,and I suppose a cry for support for myself .
Feeling sick about how I'll find her today and with what seems to be my responsibilty for bullying her to go into hospital .

She seems ok and bump.

Low sodium quite common in elderly and can often be recified by the drip. Often relating to falls/being a bit vague.

Rising potassium is more likely to be a bit dangerous, it may be from the diuretics or may be inefficient/failing kidneys.

AFAIK no option to have drip at home for this, and they usually do regular blood tests to monitor the situation.

hth, will check back later on.

That's interesting thank you so much for replying ,feel a bit reassured to learn that low sodium not that unusual.
Mother not on diueretics now ,did you mean their absence might be contributing factor to rising potassium ?
Any chance the daily anticoagulant injections she's having ( following recent hipreplacement op ) might be affecting potassium levels ?

Yes, the anticoagulant injections can cause raised potassium, but there are lots of possible causes TBH.

Diuretics - there are several different drugs that she might have been on, certainly one of the common ones can reduce the sodium level but also tends to reduce the potassium level.

If you know which one it is I can dig out some info for you and some links.

It's kind of you to reply ,I appreciate it ,thank you .
She was on furosemide ,but this has been withheld for a couple of weeks and her sodium is still falling .
Does it take a while to get out of one's system ,IYSWIM ?
The more I think about this the more I think she probably should be back in hospital ,I can see it's very complex .
It's just that it's such a harsh environment in hospital and somehow I think it won't be good for her recovery from her hip op as I think it will be harder for her to mobilise in a strange environment attached to a drip and with distant loos .
And that's before we get on to being kept awake at night ,being left stranded in bed unable to reach stuff etc
Rock and a hard place I suppose ,lesser of evils and all that .
But then again ,how lucky are we to have the option to go into hospital in first place .

The furosemide would be out of the system quite quickly, as it has a very short half-life. It would be normal to take several days for the electrolytes to improve though.

C+P a bit of info on it here -

Disturbance of electrolytes and water balance (see also section 4.4).

Furosemide leads to increased excretion of sodium, chloride, water and other electrolytes (in particular potassium, calcium and magnesium). Symptomatic electrolyte disturbances and metabolic acidosis may develop either gradually or acutely (with higher furosemide doses)

(From a reliable site)

Do you know how high her potassium is BTW? There is specific hospital treatment to bring it down if it gets too high, as it can interfere with heart rhythms.

But yes, it is wise to consider the risks of admitting to hospital.Some people get quite distressed or confused out of their own surroundings, esp with low sodium, plus risk of poor nutrition, infections etc

I'm not really sure about the potassium ,it was 5.4 while in hospital ,GP just said it was worse now .
GP - who still hasn't actually seen mum - has gone from saying she should be back in hospital to thinking maybe he could refer her to a day hospital .
I guess this is better than being an inpatient but .....we've been down that route before .
It's very protracted ,lots of hanging around ,coming back next week ,being referred to main hospital for tests and waiting for appointments and I wonder how she'll cope physically .
GP hoping to be able to fit a home visit in tomorrow . Apparently he's not sure if he can ,and he's not suggested she see another of the GP's at surgery - so maybe it's not urgent .
Except that she's getting more and more breatheless and I don't really believe that being off the duieritics and blood pressure tablets can be good for her .

Low sodium lots of causes - generally due to salt and water overload if meds have been stopped. Sounds particularly likely if she is getting breathless.
Causes of salt and water overload:

heart failure
Kidney failure
severe thyroid problems
Liver problems

Only kidney failure would cause parallel rise in potassium if drugs ahve been stopped.

Diuretics work by getting rid of salt and water from the body so the same thing can be acheived by salt and water restriction - this should only be undertaken if advised byt he GP.

Simialrly potassium can be brought down by potassium restriction . Potassium lives mainyl in fruit and vegetables and some things like coffee. Again some dietary advice would help