GranuFlo and NaturaLyte Side Effects

GranuFlo and NaturaLyte, substances used during dialysis, contain ingredients that can affect the chemistry of a human body. An imbalance of electrolytes (essential body chemicals) or metabolic abnormalities can lead to serious health complications, including potentially deadly heart problems.

Excess base (or alkaline) levels, low potassium levels and high sodium levels in the body have all been associated with GranuFlo and NaturaLyte.

Each of these conditions can result in serious health consequences, including:

• Arrhythmias (irregular heart rate) and other related heart or circulatory problems
• Muscle damage
• Seizures
• Coma
• Death

In severe cases, life-threatening paralysis may develop, especially when there is too much thyroid hormone present in the blood. This condition is called thyrotoxic periodic paralysis.

Metabolic alkalosis, sometimes referred to as alkalemia, results when the arterial blood contains excess base, or alkali. The condition is the opposite of metabolic acidosis, or excess acid. Active ingredients in GranuFlo and NaturaLyte are metabolized by the liver into a base (bicarbonate), leading to increased alkalinity in the blood.

One April 2022 study showed that alkalosis can be common in dialysis patients, especially in those who receive increased dialysis doses.

Acids and Bases in Blood

The blood is made up of acids and bases. The amount of acids and bases in the arterial blood are measured on a pH scale. An appropriate pH balance needs to be maintained in order to avoid significant health complications.

A pH measurement of 7 is considered neutral. A lower pH measurement indicates higher amounts of acid present in the blood. Typically, a normal blood pH measurement should be between 7.35 and 7.45, according to the American Association for Clinical Chemistry. A measurement above 7.45 is usually a sign of alkalosis.

Types and Causes of Alkalosis

The kidneys and lungs help to maintain the regulation of pH in the body. A decrease in carbon dioxide or an increase in bicarbonate levels makes the body too alkaline.

Patients given GranuFlo or NaturaLyte who are affected by alkalosis are typically suffering from metabolic alkalosis. When the condition is accompanied by a drop in potassium levels, patients are likely to suffer from hypokalemic alkalosis as well.

Symptoms of Alkalosis

Symptoms of alkalosis can vary depending on its cause, severity and accompanying health complications. Acute alkalosis may lead to low levels of calcium, which can result in subsequent headache, lethargy (a lack of energy and enthusiasm) and neuromuscular excitability, sometimes accompanied by delirium, tetany (intermittent muscular spasms) and seizures. Alkalosis along with low potassium can cause weakness.

It is also possible to experience chest pain and arrhythmias, or irregular heartbeats, as a symptom of alkalosis.

Early symptoms associated with alkalosis might include:

• Nausea and/or vomiting
• Numbness
• Muscle cramps
• Hand tremors

As the condition worsens and becomes more serious, symptoms might include:

• Dizziness and/or lightheadedness
• Difficulty breathing
• Confusion
• Coma
• Prolonged muscle spasms
• Stupor (a state of near-unconsciousness or insensibility)
• Shock (a life-threatening medical condition)

Treatment of Alkalosis

Treatment of alkalosis depends on the underlying cause of the condition. A patient’s outlook is better the sooner a diagnosis is made and treatment is received. People with healthy kidneys and lungs do not usually have serious alkalosis. However, alkalosis due to existing kidney problems is usually unpreventable.

Electrolyte Loss

Medicines or supplements may be given to correct any electrolyte loss, such as the loss of chloride or potassium. Fluids containing electrolytes may also be needed to correct electrolyte imbalance. Severe loss of electrolytes will require hospitalization for care. If oxygen levels are low, a patient may receive oxygen.

Alkalosis that is left untreated or treated improperly can lead to coma, electrolyte imbalance (such as low potassium levels), and arrhythmias (the heart beating too fast, too slow or irregularly).

Emergency Treatment

Alkalosis requires emergency medical attention when a patient experiences any of the following signs or symptoms:

• Confusion or inability to concentrate
• Inability to catch one’s breath or severe breathing difficulties
• Loss of consciousness
• Symptoms of alkalosis that rapidly worsen
• Seizures

Potassium is an electrolyte the body needs to work properly. It conducts electrical impulses throughout the body. Other electrolytes in the body include sodium, chloride, calcium and magnesium.

Essential Substance

Potassium is important to proper heart functioning, such as helping to keep the heartbeat regular. It also plays a role in nerve function and both skeletal and smooth muscle contractions, making it an essential component to digestion and muscular operation. Potassium helps move nutrients into cells and waste products out of cells. Finally, it assists in maintaining a normal blood pressure by maintaining healthy structure and function in the kidneys.

Potassium in Food

While potassium is an essential substance to our bodies, it is not naturally produced by the body. Therefore, it is important to eat the right foods in order to take in the recommended daily intake of potassium, which ranges from 2,300-3,400 mg per day, based on sex and life-stage groups. This is according to the guidelines established by the Institute of Medicine of the National Academies of Science.

Sources of potassium-rich foods in many people’s diets include:

• Dairy products
• Beans and nuts
• Fruit from vines, such as grapes and blackberries
• Whole grains
• Citrus fruits, such as oranges and grapefruit
• Leafy greens, such as spinach and collards
• Root vegetables, such as carrots and potatoes
• All meats and some types of fish, such as salmon, cod and flounder

Kidney Disease

The kidneys, when healthy, help to keep the right amount of potassium in the body. But for people with chronic kidney disease, the kidneys may not remove the extra potassium from the blood through the urine. Some substances, such as GranuFlo and NaturaLyte, can also affect potassium levels in patients’ blood.

Symptoms of Hypokalemia

Potassium is needed for proper cell functioning. While a small dip in potassium level may not cause any symptoms, a more significant drop can lead to serious health complications. A very low potassium level may cause heart arrhythmias (irregular heartbeat).

Mild symptoms associated with low potassium might include:

• Constipation
• Feeling of skipped heart beats or palpitations
• Fatigue
• Muscle damage
• Muscle weakness or spasms
• Tingling or numbness

More severe symptoms include abnormal heart rhythms, especially in people with heart disease. These irregular heartbeats can cause patients to feel lightheaded or faint.

The University of Maryland Medical Center reported that low potassium can also affect:

• Bone health
• Blood pressure
• Heart disease
• Stroke risk

Treatment of Hypokalemia

A blood test can be done to check a patient’s potassium level. If hypokalemia is mild, potassium supplements can be prescribed as the first line of treatment. This method of treatment may be all that is needed along with eating foods rich in potassium.

Extra Potassium

If the condition is more severe, potassium may need to be administered intravenously (IV). For patients taking diuretics, doctors may prescribe extra potassium to be taken daily. A certain type of diuretic called a potassium-sparing diuretic can also be prescribed to help keep potassium in the body.

Arrhythmias

A severe drop in potassium can lead to serious and sometimes deadly heart rhythm problems (arrhythmias).

Increased concentrations of sodium in the blood, called hypernatremia, have also been linked to the use of GranuFlo and NaturaLyte. Hypernatremia is usually due to a decrease in total body water (TBW) rather than an increase in sodium intake or other electrolyte content.

Hyperosmolality

Hyperosmolality, an increase in the osmolality of the body fluids (referring to the body’s electrolyte-water balance), can result from water loss. This condition can cause brain cell shrinkage, leading to subsequent brain injury.

Other serious complications might include:

• Cerebral edema (excess accumulation of fluid in the brain)
• Neuromuscular excitability
• Circulatory problems, such as tachycardia (faster than normal heart rate at rest) or hypotension (low blood pressure resulting in lack of blood to organs and body tissues)
• Confusion
• Seizures
• Coma
• Death
• Overactive or overresponsive reflexes (hyperreflexia)