What electrolyte imbalance is most common in patients with chronic kidney disease?

Hyperkalemia is the most common electrolyte imbalance seen in patients with chronic kidney disease (CKD) due to the kidneys' diminished ability to excrete potassium effectively. As chronic kidney disease progresses, the kidneys lose their filtration capacity, leading to a buildup of waste products and electrolytes in the body.

Potassium is primarily regulated by the kidneys, and in patients with CKD, the impaired renal function leads to retention of potassium, thus resulting in hyperkalemia. Elevated serum potassium levels can have significant clinical implications, including the risk of potentially life-threatening cardiac arrhythmias.

In contrast, while conditions such as hypomagnesemia, hypocalcemia, and hypernatremia can be encountered in patients with CKD, they are not as prevalent as hyperkalemia. Hypomagnesemia may occur because of dietary restrictions or the use of certain medications, while hypocalcemia can arise from disrupted vitamin D metabolism and secondary hyperparathyroidism commonly seen in CKD. Hypernatremia may result from fluid imbalance but is less commonly an issue compared to the retention of potassium. Thus, hyperkalemia stands out as the hallmark electrolyte disorder in the context of chronic kidney disease.