Electrolyte Imbalances In End-Stage Renal Disease (ESRD) Patients Undergoing Maintenance Hemodialysis.

Original Article

Abstract

Background: Patients with End-Stage Renal Disease (ESRD) who are on maintenance hemodialysis frequently experience electrolyte disturbances due to the combination of unregulated fluid shifts with poor kidney function and the dialysis procedure itself. These disturbances particularly increase the cardiac and neuromuscular morbidity risks, thus requiring consistent monitoring to reduce the risks. Adverse outcomes are almost unavoidable without regular monitoring.

Objectives: to assess the distribution and prevalence of electrolyte disturbances in patients on maintenance dialysis.

Methodology: This observational cross-sectional study was conducted in the Nephrology Department of Nephrology MTI.LRH Peshawar from january 2023 to Jan 2024. The study included a participant cohort of 100 ESRD patients on dialysis. All participants were undergoing hemodialysis treatment three times a week, as was standard practice. The study included pre-dialysis blood samples and then measured the serum electrolytes Na+, K+, Ca²+, and PO₄³⁻ . A 24.0 version of SPSS was employed for the analysis, with p < 0.05 as the level of significance.

Results: A 100-patient sample showed a mean age of 54.3 ± 12.7 years with a predominantly male population. 42% of patients presented with hypernatremia, 38% with hyperkalemia, 35% with hypocalcaemia, and 47% with hypophosphatemia. There were significant associations between hypophosphatemia and the duration of dialysis, and between parathyroid hormone/calcium levels and the serum measurement of calcium (p=0.032, p=0.019, respectively). For patients with more than two years of dialysis, the severity of electrolyte abnormality significantly increased. 

Conclusion: Hypernatremia and hypophosphatemia have the highest prevalence of occurrence among electrolyte abnormalities. Overall, ESRD patients receiving dialysis suffer from a high prevalence of electrolyte abnormalities. Greater outcomes with fewer medical complications result from continual patient monitoring and the development of tailored dialysis prescriptions.