Publication:

A study of serum sodium and calcium status in both hemodialysed and conservatively treated chronic kidney disease patients attending a tertiary care hospital of Assam, India

Background chronic kidney disease is a very commonly encountered health problem which if diagnosed and treated at a very early stage can increase the survivability and decrease the morbidity and mortality among these patients.

Methods The present study is a hospital based study in patients with CKD attending a tertiary care hospital in Assam, India. 71 CKD patients (31 conservatively treated and 40 hemodialysed) and 50 healthy controls were included in the study. Serum sodium and calcium was estimated in all 71 cases and 50 controls after taking written consent for being included in the study. The results were compared statistically with the controls and also between the conservatively treated and hemodialysed group.

Results Serum Na+ and calcium was significantly lower with p value 0.015 and <0.001 respectively in CKD groups as compared to the controls. Varied ranges of dyselectrolytemia were observed in the CKD group with occurrence of hyponatremia being more prevalent in CKD patients undergoing treatment with prevalence of 28.1%. Whereas prevalence of hypernatremia was found to be 12.6%. Between the conservatively treated and hemodialysed group, hyponatremia was found to be more prevalent in conservatively treated group with prevalence of 41.9%. Hypocalcemia was prominent invariably in both conservative and hemodialysed group. There was significant difference of Na+ values between CKD patients treated by hemodialysis and conservatively with p value 0.0103. Whereas no difference was observed for serum calcium between the two groups.

Conclusions In the present study, varied range of dysnatremia has been noticed in CKD patients that depend upon the mode of treatment. Early detection of dyselectrolytemia with frequent investigation and adjustment of composition of the dialysate and mode of treatment may decrease the morbidity and mortality in CKD patients.