Comparative Evaluation of Electrolyte Imbalance in Diabetic Patients with and without Acute Kidney Injury: A Cross-Sectional Clinical Study

Abstract

Background: Diabetes mellitus is a major risk factor for electrolyte disturbances and acute kidney injury (AKI), both of which contribute significantly to morbidity and mortality. Impaired renal function in diabetic patients may disrupt electrolyte and acid–base homeostasis, leading to clinically significant complications.

Objective: To compare glycemic status, renal function, electrolyte profiles, and acid–base balance among healthy controls, diabetic patients without AKI, and diabetic patients with AKI.

Methods: This comparative cross-sectional study included 150 participants equally divided into three groups: healthy controls (Group A), diabetic patients without AKI (Group B), and diabetic patients with AKI (Group C). Clinical parameters including body mass index (BMI), blood pressure, and duration of diabetes were recorded. Fasting serum glucose, HbA1c, blood urea, serum creatinine, estimated glomerular filtration rate (eGFR), sodium, potassium, chloride, and bicarbonate levels were analyzed using standard biochemical methods. Statistical analysis was performed using one-way ANOVA with Tukey’s post-hoc test and Spearman’s correlation analysis.

Results: Significant differences were observed among the study groups for glycemic, renal, and electrolyte parameters (p < 0.05). Diabetic patients with AKI exhibited the highest fasting serum glucose (286.2 ± 10.3 mg/dL), HbA1c (9.8 ± 1.6%), blood urea (78.9 ± 6.5 mg/dL), and serum creatinine (3.2 ± 0.5 mg/dL), while eGFR was significantly reduced (38.7 ± 4.6 mL/min/1.73m²). Serum potassium progressively increased from controls to diabetic patients with AKI (4.1 ± 0.05, 4.8 ± 0.06, and 5.92 ± 0.08 mEq/L, respectively; p < 0.001), whereas sodium, chloride, and bicarbonate levels significantly decreased. Correlation analysis revealed a strong negative association between eGFR and serum potassium (r = −0.682, p < 0.001) and a strong positive association between eGFR and serum bicarbonate (r = 0.574, p < 0.001).

Conclusion: Diabetic patients with acute kidney injury experience substantial deterioration in glycemic control, renal function, electrolyte balance, and acid–base status. Hyperkalemia and metabolic acidosis were the most pronounced abnormalities and were strongly associated with declining renal function. Regular monitoring of renal biomarkers and electrolyte profiles may facilitate early detection of complications and improve clinical management in diabetic patients at risk of AKI.