Which three electrolyte and acid-base abnormalities are commonly monitored in dogs with CKD?

• A. Hyperphosphatemia, hyperkalemia, and metabolic alkalosis.
• B. Hyperphosphatemia, hyperkalemia (or hypokalemia in early CKD), and metabolic acidosis.
• C. Hyperphosphatemia, hyponatremia, and metabolic alkalosis.
• D. Normophosphatemia, hyperkalemia, and metabolic acidosis.

Answer: (B)

In dogs with chronic kidney disease, the kidneys’ impaired ability to excrete waste and regulate minerals leads to common disturbances in phosphate, potassium, and acid-base balance. Serum phosphorus tends to rise because the damaged kidneys can’t clear it effectively, causing hyperphosphatemia. Potassium handling also changes as kidney function declines, so hyperkalemia is common, though early stages can show hypokalemia due to reduced intake or urinary losses. The kidney’s reduced capacity to generate bicarbonate and to excrete hydrogen ions produces metabolic acidosis. These three abnormalities are routinely monitored because they guide treatment decisions—phosphate control, potassium management, and base supplementation—to slow disease progression and improve quality of life. Metabolic alkalosis, hyponatremia, or normal phosphorus are not the typical patterns seen in CKD, making the described trio the best-fit monitoring focus.