ELECTROLYTES IMBALANCE IN ACUTE AND CHRONIC KIDNEY DISEASE PATIENTS IN FAISALABAD

Abstract

Background: Electrolyte imbalances are a common and clinically significant complication in patients with kidney disease, arising from impaired renal regulation of fluid and mineral homeostasis. Both acute kidney injury (AKI) and chronic kidney disease (CKD) are associated with disturbances in serum electrolyte concentrations; however, comparative data on electrolyte profiles between these two conditions remain limited, particularly in the Pakistani population.

Objective: This comparative cross-sectional study was conducted to compare serum sodium, potassium, calcium, and chloride levels between AKI and CKD patients and evaluate their relationship with age.

Methods:  A total of 100 participants (50 AKI, 50 CKD), aged 18–40 years, were enrolled. Patients with severe liver disease, cardiac failure, pregnancy, or receiving electrolyte replacement therapy were excluded. Serum sodium, potassium, and chloride were measured using Ion-Selective Electrode methodology; calcium was determined by colorimetric assay. Data was analyzed using SPSS version 23. Independent samples t-test and Pearson correlation analysis were applied, with p < 0.05 considered significant.

Results: The study population comprised 52% males and 48% females. Females were slightly more represented in the AKI group (52%), whereas males predominated in the CKD group (56%). The age range was 18–39 years for AKI and 22–39 years for CKD patients. Significant differences were observed between AKI and CKD patients for all measured electrolytes. Serum sodium levels were significantly lower in AKI patients (132.4 ± 3.7 mEq/L) compared to CKD patients (135.3 ± 4.2 mEq/L) (t = -3.67, p = 0.001). Potassium levels were significantly higher in AKI patients (6.0 ± 0.6 mEq/L) than in CKD patients (5.7 ± 0.6 mEq/L) (t = 2.41, p = 0.018). Serum calcium levels were slightly higher in AKI patients (7.9 ± 0.5 mg/dL) compared to CKD patients (7.7 ± 0.5 mg/dL) (t = 2.09, p = 0.039). The greatest difference was observed in serum chloride levels, with AKI patients exhibiting significantly lower values (93.8 ± 2.8 mEq/L) compared to CKD patients (99.8 ± 3.2 mEq/L) (t = -9.98, p < 0.001). Age showed significant correlations with sodium (r = 0.29, p = 0.004), calcium (r = -0.21, p = 0.036), and chloride (r = 0.41, p < 0.001), whereas no significant association was found with potassium levels (r = 0.18, p = 0.071).

Conclusion: Significant electrolyte disturbances exist in both AKI and CKD patients, with distinct electrolyte profiles observed between the two conditions. AKI patients demonstrated lower sodium and chloride levels and higher potassium concentrations compared with CKD patients. Age was significantly associated with sodium, calcium, and chloride levels, indicating that advancing age may influence electrolyte balance in kidney disease. Regular monitoring of serum electrolytes may aid in the early detection, management, and prevention of complications associated with kidney disease.