DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20201924

Comparative study of serum electrolytes Na+, K+, Ca++ in patients of chronic kidney disease in relation to its severity

Bibhu P. Behera

Abstract


Background: Chronic kidney disease (CKD) is a worldwide public health problem. Globally, CKD is the 12th cause of death and the 17th cause of disability, respectively. Yearly incidence of ESRD in India is approximately 150-200 pmp.

Methods: The observational study was conducted in Department of General Medicine, Pandit Raghunath Murmu Medical College Hospital, Baripada between May 2018 and January 2019. 244 patients of Chronic Kidney Disease above 15 years of age satisfying the inclusion and exclusion criteria were included in the study.

Results: Study group constitutes 64.34% (157) of male and 35.66% (87) of female patients with M:F of 1.8:1. The average age of the patients in the study was 55.91±12.49 yrs. 42.21% (103) of the patients were between 46 and 60 years of age. Maximum number of cases (190 cases) (77.87%) are in stage 4 and 5 with e-GFR <30 ml/ min. The average serum electrolytes in this study group for serum sodium, potassium, calcium are 137.31±10.05 mEq/L, 4.12±1.48 mEq/L and 1.10±0.19 mmol/L respectively. When association of hypokalemia with risk factor (known and unknown) is compared, chi-square value found to be 13.664 (p=0.0002) which is statistically extremely significant.

Conclusions: Authors found significant number of cases, more commonly younger patients, presented with atypical manifestations having no specific etiology; the cause may be defect in rennin-angiotensin system or, may be genetic or, may be environmental.


Keywords


Atypical hyponatremia, Atypical hypokalemia, Atypical hypocalcaemia, Chronic kidney disease, Glomerular filtration rate

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References


Bargman JM, Skorecki K. Chronic kidney disease in Harrison’s principles of internal medicine. Vol 2. 20th ed. McGraw-Hill Publication; 2018:2111-2121.

Veerappan I, Abraham G. Chronic kidney disease: current status, challenges and management in India. In Medicine Update. Mumbai: Association of Physicians of India, 2013, 593-597. Available at: http://www.apiindia.org/medicine_update_2013/ chap130.pdf. Accessed 14 January 2020.

Modi GK, Jha V. The incidence of end-stage renal disease in India: a population-based study. Kidn Internat. 2006 Dec 2;70(12):2131-3.

Agarwal SK, Dash SC, Irshad M, Raju S, Singh R, Pandey RM. Prevalence of chronic renal failure in adults in Delhi, India. Nephrol Dialy Transplantat. 2005 Aug 1;20(8):1638-42.

Mani MK. Prevention of chronic renal failure at the community level. Kidn Internat. 2003;63:S86-9.

Mani MK. Experience with a program for prevention of chronic renal failure in India. Kidn Internat. 2005 Apr 1;67:S75-8.

Mani MK. Nephrologists sans frontieres: preventing chronic kidney disease on a shoestring. Kidn Internat. 2006 Sep 1;70(5):821-3.

CKD registry of India: Indian Society of Nephrology. Available at: http://www.ckdri.org. Accessed 20 January 2020.

Taal MW, Brenner BM. Adaptation to nephron loss. In: Brenner BM, Levine SA, eds. The Kidney. Saunders Elsevier, Philadelphia; 2008: 783-793.

Levey AS, Eckardt KU, Tsukamoto Y, Levin A, Coresh J, Rossert J, et al. Definition and classification of chronic kidney disease: a position statement from Kidney Disease: Improving Global Outcomes (KDIGO). Kidn Internat. 2005 Jun 1;67(6):2089-100.

Kim S, Lim CS, Han DC, Kim GS, Chin HJ, Kim SJ, Cho WY, Kim YH, Kim YS. The prevalence of chronic kidney disease (CKD) and the associated factors to CKD in urban Korea: a population-based cross-sectional epidemiologic study. J Korean Medi Scie. 2009 Jan 1;24(Suppl 1):S11-21.

Imai E, Horio M, Iseki K, Yamagata K, Watanabe T, Hara S, et al. Prevalence of chronic kidney disease (CKD) in the Japanese general population predicted by the MDRD equation modified by a Japanese coefficient. Clini Experime Nephrol. 2007 Jun 1;11(2):156-63.

Jha V. Herbal medicines and chronic kidney disease. Nephrology. 2010 Jun;15:10-7.

Lai MN, Lai JN, Chen PC, Tseng WL, Chen YY, Hwang JS, et al. Increased risks of chronic kidney disease associated with prescribed Chinese herbal products suspected to contain aristolochic acid. Nephrology. 2009 Mar;14(2):227-34.

Lightstone L, Rees AJ, Tomson C, Walls J, Winearls CG, et al. High incidence of end-stage renal disease in Indo-Asians in the UK. QJM: Internat J Medi. 1995 Mar 1;88(3):191-5.

Bandara JM, Senevirathna DM, Dasanayake DM, Herath V, Bandara JM, Abeysekara T, et al. Chronic renal failure among farm families in cascade irrigation systems in Sri Lanka associated with elevated dietary cadmium levels in rice and freshwater fish (Tilapia). Environm Geochemist Health. 2008 Oct 1;30(5):465-78.

Yee J, Parasuraman R, Narins RG. Selective review of key perioperative renal-electrolyte disturbances in chronic renal failure patients. Chest. 1999 May 1;115(5):149S-57S.

Korgaonkar S, Tilea A, Gillespie BW, Kiser M, Eisele G, Finkelstein F, Kotanko P, Pitt B, Saran R. Serum potassium and outcomes in CKD: insights from the RRI-CKD cohort study. Clini J Am Soci Nephrol. 2010 May 1;5(5):762-9.

Peacock M. Calcium metabolism in health and disease. Clini J Am Soci Neph. 2010 Jan 1;5(Supplement 1):S23-30.