Chulalongkorn Medical Journal


Background : Hyperkalemia, hyperphosphatemiaand metabolic acidosis arecommon complications among chronic kidney disease (CKD)patients. However, there were several reports of hypokalemia inpopulation resides in the northeast of Thailand. The prevalence ofelectrolyte imbalance in CKD patients in this region was still unknown.Objective : To study the prevalence of potassium, phosphate and acid-baseimbalance in CKD patients in the central northeast of Thailand.Design : Cross-sectional descriptive studySetting : Roi-et, Mahasarakham, Khonkaen and Kalasin Provincial publichealth offices.Material and Method : We used specific My SQL query command for retrieving laboratorydata between Jan 1st - Dec 31st, 2014 from the databases of fourprovincial public health offices regarding ICD 9 and 10 of pre-dialysisCKD codes.Result : In total, databases of 31,180 CKD patients were retrieved.The mean estimated glomerular filtration rate (eGFR), serumpotassium, phosphate and bicarbonate were 34.7 ± 24.6 ml/min/1.73 m2, 4.2 ± 0.7 mEq/L, 4.1 ± 1.6 mg/dL and 24.2 ± 4.3 mEq/L,respectively. CKD 5 had the highest prevalence of hyperkalemia,hyperphosphatemia and metabolic acidosis (39.9%, 41.5% and40.8%, respectively). The overall prevalences of hyperkalemiaand hyperphosphatemia were higher than hypokalemia andhypophosphatemia (30.1% and 30% vs.10.6% and 7%); however,the prevalence of metabolic alkalosis was higher than metabolicacidosis (30.9% vs. 26.1%). The eGFR correlated positively withserum bicarbonate (r = 0.30, p <0.01) and negatively with serumpotassium and phosphate (r = -0.19 and - 0.29, p <0.01).Conclusion : Hyperkalemia and hyperphosphatemia were major metaboliccomplications among CKD patients in the central northeast ofThailand. Contrary to our knowledge, the prevalence of metabolicalkalosis was higher than metabolic acidosis in these patients.


Faculty of Medicine, Chulalongkorn University

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