Clinical Characteristics and Outcomes of CKD Patients Presenting with Fluid and Electrolyte Disorders: A Prospective Observational Study

Open Access

Abstract

Introduction: Chronic kidney disease (CKD) is a progressive and irreversible disorder characterized by persistent decline in renal function, leading to impaired regulation of fluid balance, electrolyte homeostasis, and acid–base equilibrium. Fluid retention and electrolyte disturbances become increasingly common with worsening renal function, particularly in advanced stages of CKD. Important complications include fluid overload, hyperkalemia, metabolic acidosis, and dysnatremias such as hyponatremia, all of which contribute significantly to morbidity and mortality in CKD patients.  This study aimed to determine the clinical characteristics and short-term outcomes of hospitalized CKD patients presenting with fluid and electrolyte disorders. Methods & Materials-This prospective observational study was conducted at the Dialysis Center of International Medical College Hospital from January 2025 to December 2025. A total of 58 adult patients with CKD presenting with fluid and electrolyte imbalance were enrolled. Patient assessment included demographic and clinical evaluation, electrolyte and arterial blood gas analysis, stage of CKD, and treatment interventions during hospitalization. Data analysis was performed using SPSS version 25.0. Results-The study population consisted predominantly of middle-aged males, with a high burden of advanced CKD. Diabetic nephropathy was the most common underlying etiology. Fluid overload and electrolyte disorders were frequently observed, including hyperkalemia (53.4%), hyponatremia (50.0%), hyperphosphatemia (58.6%), hypocalcemia (44.8%), and metabolic acidosis (56.9%). The prevalence of electrolyte imbalance increased significantly with progression of CKD stage. Clinical improvement was achieved in 70.7% of patients following fluid restriction, diuretics, potassium-lowering strategies, bicarbonate therapy, and dialysis as required. Hemodialysis was required in 32.8% of cases. Conclusion- Fluid and electrolyte disorders were highly prevalent among hospitalized CKD patients, particularly in advanced stages. More than half of the patients had hyponatremia, hyperkalemia, and metabolic acidosis, and these abnormalities demonstrated significant association with stage progression. Appropriate intervention strategies including fluid restriction, diuretic therapy, potassium-lowering measures, sodium bicarbonate supplementation, and initiation of dialysis improved short-term outcomes in the majority of patients.