Electrolyte Monitoring in Clinical Practice

Patient Assessment and Monitoring

• The American College of Cardiology recommends measuring serum electrolytes daily during IV diuretic administration or active titration of heart failure medications 2
• In patients at increased risk of acute kidney injury, measure serum urea, creatinine, and electrolytes at least every 48 hours, or more frequently if clinically indicated 1
• Electrolyte monitoring should occur every 4-12 hours in critically ill patients with acute kidney injury or on continuous renal replacement therapy 1, 2
• The American College of Cardiology suggests that hypokalemia and hypomagnesemia from diuretics can precipitate serious cardiac arrhythmias, especially with concurrent digitalis therapy 3, 4
• The risk of electrolyte depletion is markedly enhanced when two diuretics are used in combination, according to the American College of Cardiology 3, 4