RỐI LOẠN ĐIỆN GIẢI Ở BỆNH NHÂN MẮC BỆNH THẬN MẠN CHƯA ĐIỀU TRỊ THAY THẾ

Abstract

Objective: Assessment of Electrolyte disorders (Sodium, Potassium, Chloride) in Patients with Chronic Kidney Disease without renal replacement therapy at the Nephrology and Dialysis Center, Bach Mai Hospital. Methods: A cross-sectional descriptive study was conducted on 200 patients with stage 3 to 5 chronic kidney disease who had not yet undergone renal replacement therapy at the Nephrology and Dialysis Center, Bach Mai Hospital from January 2024 to March 2025. Results: A total of 200 patients with stage 3–5 chronic kidney disease without renal replacement therapy were included in the study. The mean age of the cohort was 56,54 ± 15,636 years, with the majority being over 60 years old (50,5%, n = 101). Male patients accounted for 54% of the study population, while females represented 46%. The most common clinical manifestations were hypertension (91%), anemia (63%), and fatigue (27%). Hyponatremia was observed in 10% of patients, with prevalence rates of 3,5% in stage 3 CKD, 3,0% in stage 4, and 3,5% in stage 5. There was no statistically significant difference in the prevalence of hyponatremia among the three CKD stages (p = 0,965). No cases of hypernatremia were detected. Hyperkalemia was present in 21% of patients, including 11% in stage 5, 8% in stage 4, and 2% in stage 3 CKD. Hypokalemia was identified in 9,5% of patients. The differences in the prevalence of hyperkalemia and hypokalemia among CKD stages were statistically significant (p = 0,001). Hypochloremia was found in 1% of the patients, whereas hyperchloremia was observed in 5%. Conclusion: Both hyperkalemia (21%) and hypokalemia (9,5%) were observed, with hyperkalemia being more prevalent. Hyponatremia was present in 10% of patients, while no cases of hypernatremia were detected. These imbalances may result in life-threatening complications such as arrhythmias, ventricular fibrillation, seizures, and cardiac arrest. Early detection and timely correction of electrolyte disturbances are crucial to improving clinical outcomes and reducing mortality in patients with chronic kidney disease.