Electrolyte Dysregulation in Diabetic with Advanced Chronic Kidney Diseases (CKD): Comparative Analysis of CKD Stages 4 and 5

Background: Electrolyte imbalance is common in both diabetes mellitus (DM) and chronic kidney disease (CKD). While they may occur independently, their coexistence can exacerbate metabolic disturbances, thereby accelerating disease progression and impairing quality of life. Objective: to investigates the differences in electrolyte profiles between patients with CKD stages 4 and 5 with DM.Methods: A cross-sectional comparative design study was employed. A hundred participants (50 with CKD stage 4 and 50 with CKD stage 5 with DM) were recruited from a clinical laboratory during May to June 2024. Serum natrium, kalium, and chloride levels were measured alongside urea, creatinine, GFR, and glucose. The Mann-Whitney U test was applied to compare the electrolyte levels between these CKD stages.Results: Of 100 participants, more men participating in this study (66% vs. 34%). Pre-elderly (45-59 y.o.) was the most predominant (61%), followed by elderly (>60 years, 20%), and adult (26-45 y.o., 19%). Both groups showed elevated urea, creatinine, and glucose levels with reduced GFR, confirming advanced CKD and DM. There was no significant difference in glucose level between stage 4 and stage 5. A significant difference (p=0.001) was observed in natrium levels, with stage 5 CKD patients exhibiting lower levels compared to those in stage 4. In contrast, kalium and chloride levels showed no significant difference (p=0.71 and p=0.81, respectively) in both groups.Conclusion: This study highlights the specific vulnerability of natrium homeostasis in advanced CKD with diabetes. Natrium dysregulation observed in stage 5 CKD underscores the need for close monitoring and management of sodium levels in this population.