Method-dependent Variation in Serum Electrolytes: A Cross-sectional Study Comparing Direct and Indirect Ion-selective Electrodes

Background Metabolic acidosis is defined by blood pH below 7.32 (venous), resulting from acid accumulation or bicarbonate loss, and classified as high anion gap (HAGMA) or normal anion gap (NAGMA). This case highlights the importance of understanding the limitations of analytical methods in diagnosing metabolic acidosis. A 47-year-old male with IgA lambda multiple myeloma complicated by cast nephropathy and chronic kidney disease presented with hypoxia, dyspnea, and chest pain one day after chemotherapy administration. On admission, his oxygen saturation was 70% due to volume overload in the context of hypertension and acute kidney injury. He received oxygen, antihypertensives, intravenous steroids, and diuretics, which improved his clinical symptoms. Notably, his total serum protein and M-spike were 11.2 g/dL, and 6.5 g/dL, respectively, measured 12 days prior to admission. Laboratory evaluation during this admission showed profound hypobicarbonatemia of 10 mmol/L with HAGMA of 22, total protein of 10.5 g/dL, and monoclonal free lambda light chain of 1170 mg/L. Therefore, the patient was treated with intravenous bicarbonate infusion. The total bicarbonate remained low on the repeat measurement by chemistry analyzer, and the etiology of the hypobicarbonatemia was termed “remained unclear” by the clinical team. The bicarbonate level and pH were later determined with a blood gas analyzer, resulting in values of 7.35 and 22 mmol/L and the bicarbonate therapy was discontinued. His estimated M-spike and total protein decreased after chemotherapy, and both the blood gas and total bicarbonate levels were within the reference range. Methods Two different methods for determining serum bicarbonate were used: the Radiometer ABL800 FLEX blood gas analyzer and the Ortho Clinical Diagnostic VITROS System 5600 ECO2 Slide. The ABL800 FLEX uses direct ion-selective electrodes (ISE) to measure pH and pCO2 and calculate bicarbonate via the Henderson-Hasselbalch equation. The VITROS ECO2 Slide, a dry chemistry tool, measures total carbon dioxide (bicarbonate plus dissolved CO2) with enzyme-driven reactions and reflectance spectrophotometry. Results See Table. Note that due to interference with the Ortho bicarbonate values remain very low despite the normal pH levels. Conclusion This case with hyperproteinemia in a patient with multiple myeloma demonstrates pseudohypobicarbonatemia, which is the first reported case using the Ortho Clinical Diagnostics VITROS series. Pseudohypobicarbonatemia is a condition in which bicarbonate levels in the blood appear falsely low due to analytical interference, such as light absorbance and scattering caused by hyperproteinemia or hyperlipidemia. This occurs in the spectrophotometric method, where the sample reduces the light intensity due to absorption, rather than indicating a true physiological deficiency, potentially leading to confusion for clinicians. Pseudohypobicarbonatemia can be accurately confirmed using direct potentiometry ISE methods on a blood gas analyzer, which measures bicarbonate in whole blood without the need for sample pretreatment or dilution and is unaffected by turbidity or high protein levels. This case highlights the potential for misinterpretation of metabolic acidosis due to discrepancies between laboratory measurement methods. Pseudohypobicarbonatemia can led to unnecessary testing and treatment, and prolong hospital stay. Clinicians should be mindful of the limitations of various testing methods to improve patient management.

Electrolyte disturbances are relatively common in patients with depression, but they are often overlooked, and the relationship between electrolyte changes and adverse outcomes in depression is not yet clear. This study aims to explore the impact of serum electrolyte levels on the all-cause and cardiovascular disease (CVD) mortality rates in patients with depression. This prospective cohort study included 3127 patients with depression who participated in the National Health and Nutrition Examination Survey (NHANES) from 2005 through 2018. Depression was assessed using the Patient Health Questionnaire (PHQ-9), with a PHQ-9 score ≥10 defined as depression. The data were analyzed from April 1 to July 30, 2024. Multivariable Cox proportional hazards regression model was used to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs) between serum sodium, potassium, and chloride levels and the CVD risk and all-cause mortality in patients with depression. Three multivariable models were constructed. We further stratified the analysis by age, gender, hypertension, smoking, alcohol consumption, diabetes, and drinking status. Interaction significance was estimated using P-values for the product terms between serum sodium, potassium, chloride, and stratification factors. This cohort study included data from 2946 participants in the analysis (mean [SD] age, 50.13 [16.48] years; 1116 men [37.88]); During a median (IQR) follow-up of 7.2 (3.6-10.5) years, 398 deaths were recorded, of which 117 were attributed to CVD.After multivariable adjustment, compared with participants in the first quartile of serum sodium levels, the HRs of CVD mortality were 0.90(95% CI, 0.53-1.53) in the fourth quartile (p for trend = 0.484). The HRs of all-cause mortality were 0.73(95% CI, 0.55-0.99) for the fourth quartile (p for trend = 0.003). A nonlinear association was observed between serum sodium levels and all-cause mortality in patients with depression (p for overall = 0.003, p for nonlinear = 0.047). Compared with participants in the first quartile of serum potassium levels, the HRs of CVD mortality were and 1.58(95% CI, 0.98-2.54) in the fourth quartile (p for trend = 0.050), the HRs of all-cause mortality were 1.52(95% CI, 1.16-1.99) for the fourth quartile (p for trend <0.001). A nonlinear association was observed between serum potassium levels and all-cause (p for overall<0.001, p for nonlinear = 0.005) and CVD (p for nonlinear = 0.003) mortality in patients with depression. Compared with participants in the first quartile of serum chlorine levels, the HRs of CVD mortality were 0.84(95% CI, 0.49-1.46) in the fourth quartile(p for trend = 0.284). The HRs of all-cause mortality were 0.70(95% CI, 0.51-0.95) for the fourth quartile(p for trend <0.001). A nonlinear association was observed between serum chlorine levels and all-cause (p for nonlinear<0.001) and CVD (p for nonlinear<0.001) mortality in patients with depression. This cohort study found that in patients with depression, higher sodium is significantly correlated with lower all-cause mortality, higher potassium is significantly correlated with higher all-cause and CVD mortality, and higher chloride is significantly correlated with lower all-cause and CVD mortality.

Background: Acute myocardial infarction (AMI) is one of the leading causes of morbidity and mortality across the world. Very few studies were done to see the association of renal function tests and serum electrolytes with acute myocardial infarction. Objectives: To study the renal function tests like blood urea and serum creatinine with serum electrolytes like serum sodium, potassium and chloride in patients with acute myocardial infarction. Material and Methods: This case control study was carried on 50 AMI patients and 50 healthy controls. 5 ml of blood was drawn from each patient within 6 hrs. of AMI, to estimate blood urea, serum creatinine, serum sodium, serum potassium, serum chloride and cardiac marker CK-MB. The same biochemicals were also determined in 50 age and gender matched controls for comparison. Results: We found significantly increased levels of blood urea and serum creatinine in AMI patients as compared to controls. We also found statistically significant decreased levels of serum sodium, serum potassium and non-significant difference in the levels of serum chloride in AMI cases as compared to controls. Conclusion: We found altered changes in the blood urea and serum creatinine in AMI with hyponatremia and hypokalemia which may act as indicator of injury to myocardium. Further studies are needed to correlate all these parameters with the prognosis of AMI.

Background: Preeclampsia is a clinical condition in which the patient is suffering from hypertension and proteinuria, which may be associated with pathological edema. There are multiple systems involved in pre-eclampsia which is the main culprit to complicate the pregnancy. In developing nations, approximately 4–18% of pregnancies are complicated by preeclampsia which is a major cause of morbidity and mortality globally. It does not affect pregnant females only, but may be life-threatening for growing fetuses too. If we consider the mortality in all pregnant females, about 10–15% of maternal deaths are due to pre-eclampsia. Aims and Objectives: The main objective of this study is to compare the serum calcium, magnesium, sodium and potassium level in preeclampsia patients and normal pregnant women. Materials and Methods: After taking written consent from the patients, randomly 50 pregnant females diagnosed by a gynecologist as suffering from preeclampsia were selected and for the control group 50 pregnant females who came for routine checkups were selected. 5 ml of blood was collected in the clot activator tube. The samples were analyzed for serum calcium, magnesium, sodium, and potassium on a fully automated biochemistry analyzer ”Erba XL 640” in HiTech, clinical biochemistry laboratory, B.J medical college, Ahmedabad. Results: The result showed a decreased level of serum calcium, magnesium, sodium, and potassium in the study group compared to the control group. The S. calcium level was (7.624 ± 0.84) and (8.52 ± 0.80) mg/dl in the study and control groups respectively. The S. magnesium level in the study and control were (1.47 ± 0.25) and (1.79 ± 0.18) mg/dl, respectively. S. sodium levels were (131.46 ± 6.96) and (139.92±7.86) mEq/L in the study and control groups, respectively. And the level of S. potassium in the study and control groups was (3.39 ± 0.52) and (3.67 ± 0.38) mEq/L, respectively. All the parameter values are significantly lower in a study group in comparison to control group patients (P &lt; 0.001). Conclusion: From our study, we have concluded that the serum level of some parameters such as calcium, magnesium, sodium, and potassium was significantly decreased in patients suffering from preeclampsia. We can also conclude that these parameters can be used as a biomarker for the diagnosis of preeclampsia.

PURPOSE: To compare biochemical and haematological characteristics of underground mine-workers with EAMC with a control group of non-cramping mine workers after a work shift. METHODS: Retrospective descriptive haematological and biochemical profiles of underground mine workers who presented with EAMC over 18 months in a South African gold mine (CRA group) was compared with a prospective control group of similar workers without EAMC from which data were collected before (CONPRE) and after (CONPOST) 8 hour shifts. Despite the large number of CRA participants, some data were non-parametric. Results were summarized using medians and percentiles where appropriate. For comparison of categorical variables, the Chi2 and Fisher-exact tests were used. 95% confidence intervals indicated significant differences between the medians of paired scale data sets. RESULTS: Significant differences between the CRA group and the CONpost group showed signs of dehydration (increased haematocrit and haemoglobin; p<0.001), inflammation (elevated total white cell count; p<0.001), elevated urea and creatinine (p<0.001), and lower fluid intake (p<0.001). Serum sodium and chloride levels were not significantly different between the CRA and CONpost groups. Muscle damage was indicated by elevated but similar (p=0.2) creatine kinase (CK) and in both the CRA and CONpost groups. The most important finding was significantly higher serum myoglobin in the CRA group compared to the CONpost group (median of 51ng/ml compared to 186.5 ng/ml; p<0.001). CONCLUSION: EAMC is associated with elevated inflammatory markers, dehydration and hemoconcentration, elevated creatinine and protein levels. If corrected for dehydration, reduced serum chloride and sodium levels may be shown. Significantly higher s-myoglobin levels in miners with EAMC compared to a control group indicate an association between muscle damage and EAMC. Further investigation into the pathogenesis of EAMC will be guided by these results.

The dynamic surface tension (DST) data and biochemical parameters (BCP) of animal blood have been obtained. A strong positive correlation was found for goats between σ1, σ2, σ3 (DST) and sodium levels (BCP), λz (DST)—with the levels of lipid and sodium (BCP); whereas a strong negative correlation was found for goats between σ3 (DST) and the level of total protein and chloride (BCP), λz (DST)—with the level of albumin (BCP). A strong positive correlation was found for horses between σ1, σ2, σ3 (DST) and lipid levels (BCP); λ0 (DST)—the level of chloride (BCP); λz (DST)—the level of albumin and chloride (BCP). A strong negative correlation was found for horses between σ1 (DST) and sodium level (BCP); σ2, σ3 (DST) and chloride level (BCP); λ0 (DST) and lipid level (BCP). Some moderate and weak correlations of different types were also found, but these have less importance for practical usage. The particular correlations between BCP and DST data of the same serum samples allowed DST data to be checked directly at the farm, and requiring the use of more expensive and time-consuming biochemical analysis only in cases of high necessity for a particular animal.

Pseudonormo- and Pseudohypernatraemia in sick neonates

Simple SummaryInhibitors of phosphodiesterase 4 (PDE4), a group of isoenzymes that hydrolyze and inactivate the second messenger cAMP, produce promising therapeutic benefits, including anti-inflammatory and memory-enhancing effects. Here, we report that, unexpectedly, PDE4 inhibitors also reduce serum potassium levels in mice. As both the total potassium content of the body, as well as the distribution of potassium between intra- and extracellular compartments, are critical for normal cellular functions, we further explored this observation. Several structurally distinct PDE4 inhibitors reduce serum potassium levels in mice, suggesting it is a class effect of these drugs. Serum potassium levels decrease within 15 min of drug injection, suggesting that PDE4 inhibition lowers serum potassium levels by promoting a transcellular shift of potassium from the blood into cells. This shift is a characteristically fast process, compared to a loss of total-body potassium via the kidneys or digestive tract (e.g., diarrhea). Indeed, stimulating cAMP synthesis with β-adrenoceptor agonists is known to rapidly shift potassium into cells, and PDE4 inhibitors appear to mimic this process by preventing PDE4-mediated cAMP degradation. Our findings reveal that the various acute physiologic effects of PDE4 inhibitors are paralleled and/or may be affected by reduced serum potassium levels.The analysis of blood samples from mice treated with the PDE4 inhibitor Roflumilast revealed an unexpected reduction in serum potassium levels, while sodium and chloride levels were unaffected. Treatment with several structurally distinct PAN-PDE4 inhibitors, including Roflumilast, Rolipram, RS25344, and YM976 dose-dependently reduced serum potassium levels, indicating the effect is a class-characteristic property. PDE4 inhibition also induces hypothermia and hypokinesia in mice. However, while general anesthesia abrogates these effects of PDE4 inhibitors, potassium levels decrease to similar extents in both awake as well as in fully anesthetized mice. This suggests that the hypokalemic effects of PDE4 inhibitors occur independently of hypothermia and hypokinesia. PDE4 inhibition reduces serum potassium within 15 min of treatment, consistent with a rapid transcellular shift of potassium. Catecholamines promote the uptake of potassium into the cell via increased cAMP signaling. PDE4 appears to modulate these adrenoceptor-mediated effects, as PDE4 inhibition has no additional effects on serum potassium in the presence of saturating doses of the β-adrenoceptor agonist Isoprenaline or the α2-blocker Yohimbine, and is partially blocked by pre-treatment with the β-blocker Propranolol. Together, these data suggest that PDE4 inhibitors reduce serum potassium levels by modulating the adrenergic regulation of cellular potassium uptake.

Background: Cataract is one of the leading causes of blindness in developing countries. The most common type of cataract is senile cataract. The exact pathogenesis of cataract is not known, but it is believed that age, sex, radiation and serum electrolyte changes are important responsible risk factor. Rise in serum sodium level is responsible for formation of cataract. Potassium and chloride are not responsible factor for formation of cataract as that of serum sodium level. The purpose of this study is to estimate serum sodium and potassium in senile cataract patients, as compared to those without cataract. Methods: This study consists of 100 senile cataract patients and age matched 100 normal healthy individuals without cataract, serum electrolyte is measured by using an electrolyte analyzer. Results: In our study there is significant rise in serum sodium and chloride levels in cases compare to control group which is statistically significant. Serum potassium levels are in significant. Conclusion: We have concluded that serum sodium and chloride are important markers of senile cataract formation. Restrictions of salt in the diet delay the process of cataract formation.

Babesiosis caused by Babesia ovis is a major threat to the livestock industry worldwide. In Pakistan, the Lohi sheep breed is an important economic resource, but limited information is available on the impact of B. ovis infection on this breed. This study aimed to investigate the serum electrolyte and trace element variations between B. ovis-infected and uninfected Lohi sheep from Pakistan. A total of 97 Lohi sheep was stratified based on the geographical distribution of Multan district, employing a multistage cluster sampling method. Blood and serum samples were collected from randomly selected sheep, and DNA extraction and PCR amplification were performed to detect B. ovis infection. Serum electrolyte and trace element levels were analyzed in infected (n=67) and uninfected (n=30) groups, stratified by age and gender. The study revealed a 69.07% overall infection rate of B. ovis in Lohi sheep. Infected sheep showed significantly elevated serum copper levels (p&lt;0.0001), with no substantial differences observed in serum iron, sodium, potassium, and chloride levels. However, age-wise variance analysis revealed statistically significant variations in sodium and potassium levels (p&lt;0.0001 and p&lt;0.05, respectively). Notably, serum chloride levels differed between infected and uninfected females in individuals younger than two years (p&lt;0.05). Serum iron levels remained consistent across different age groups. Comparative analysis indicated a higher prevalence of electrolyte imbalances, such as hyponatremia, hyperkalemia, hyperchloremia, and hypoferremia, in infected sheep compared to normal reference ranges, while instances of hypernatremia, hypokalemia, hypochloremia, and hyperferremia were less frequent. In conclusion, our study suggests that B. ovis infections could lead to alterations in serum electrolyte and trace element levels in Lohi sheep, emphasizing the importance of further research into the specific mechanisms driving these alterations to enhance disease management strategies tailored to this breed.

ObjectivesPrimary objective was to study the correlation between serum chloride levels at admission and at regular intervals with the mode and degree of respiratory support provided in cases of respiratory failure. Correlation between the serum chloride levels and patient's outcome over next 48 hours in the form of improved, progressed or died was the secondary objective.Materials and methodsAfter informed consent and approval from Institutional Ethics Committee, patients presenting with respiratory failure (requiring oxygen support for spo2 >92% or partial pressure of oxygen (PaO2) <60 mm Hg or partial pressure of carbon dioxide (PCO2) > 50 mm Hg) on room air were enrolled. Patients with chronic kidney disease, chronic liver disease, recent myocardial infarction, stroke, peripheral motor neuropathy, patients intubated prior to arrival in the Emergency Department, diabetic ketoacidosis, traumatic brain injury were excluded. Serum chloride levels were measured at admission and at regular intervals (2 hours, 6 hours, 12 hours, 24 hours, 36 hours and 48 hours) post admission to the hospital. Additional clinical data, including type and degree of respiratory support and outcomes, were documented to assess the relationship between serum chloride dynamics and patient response to treatment. Any patient who got intubated within 2 hours were excluded from the study. Initial choice of respiratory support was on clinician's discretion depending on clinical parameters and arterial blood gas analysis.ResultsA total of 139 patients were enrolled, out of which 48 were females. Fifteen patients got intubated within 2 hours of presentation to emergency and were excluded. Mean age of patients enrolled were 46.04 ± 12.34 years [95% CI = 43.86 – 48.22]. Mean chloride levels all patients presenting with respiratory failure were on the lower side 95.29 ± 4.81 mEq/L [95% CI = 93.1-97.47]. Two factor ANOVA showed no significant effect of chloride on the mode of ventilatory support (p= 0.744), but increasing trend of chloride levels at 36 hours (normalisation of initial hypochloremia) was significantly associated with improved outcome (OR 1.35, 95% CI =1.2- 1.52, p<0.001). On Spearman correlational analysis, there was significant small positive correlation between chloride levels at admission and improved outcome of patient [r(124) = 0.27, p = 0.001] and medium negative correlation between chloride levels at 36 hours and improved outcome of patient [r(124) = -0.5, p = 0.01].ConclusionThere was a significant interaction between chloride levels over time and the outcome of patient. It provides insights into the potential temporal influence of chloride levels on patient outcomes, highlighting the need for further investigation in clinical settings to validate these associations. Thus, by identifying high-risk patients based on serum chloride trends, healthcare systems can optimise resource allocation.

Introduction There is a dearth of comprehensive studies on the association between serum electrolyte and adverse short-term prognosis of Chinese patients with acute decompensated heart failure (ADHF). Patients and methods A total of 5166 patients with ADHF were divided into four serum electrolyte-related study populations (potassium (n = 5145), sodium (n = 5135), chloride (n = 4966), serum total calcium (STC) (n = 4143)) under corresponding exclusions. Different logistic regression models were utilized to gauge the association between these electrolytes or the number of electrolyte abnormalities and the risk of a composite of all-cause mortality or 30-day heart failure (HF) readmission. Results In multivariable adjusted analysis, patients with potassium below 3.5 mmol/L (odds ratios (ORs) 1.45; 95% confidence interval (CI):1.07–1.95), 4.01–4.50 mmol/L (OR: 1.29, CI: 1.02–1.62), 4.51–5.00 mmol/L (OR: 1.43, CI: 1.08–1.90) and above 5.00 mmol/L (OR: 1.74, CI: 1.21–2.51) had an increased risk of outcome when compared with potassium at 3.50–4.00 mmol/L. Sodium levels were inversely related to the risk of a composite outcome (<130 mmol/L: OR: 2.73 (95% CI, 1.81–4.12); 130–134 mmol/L: OR, 1.97 (CI, 1.45–2.68); 135–140 mmol/L: OR, 1.45 (CI, 1.17–1.81); p for trend < 0.001) in comparison with sodium at 141–145 mmol/L. Chloride < 95 mmol/L corresponded to a higher risk of a composite outcome with an OR of 1.65 (95% CI, 1.16–2.37) in contrast to chloride levels at 101–105 mmol/L. In addition, the adjusted ORs (95% CI) for a composite outcome comparing the STC < 2.00 and 2.00–2.24 vs. 2.25–2.58 mmol/L were 0.98 (0.69–1.43) and 1.13 (0.89–1.44), respectively. Besides that, the number of electrolyte abnormalities was positively related to the risk of a composite outcome (N = 1, OR 1.40, 95% CI: 1.13–1.73; N = 2, OR 2.51, 95% CI: 1.85–3.42; N = 3, OR 2.47, 95% CI: 1.45–4.19; p for trend < 0.001) in comparison with N = 0. Conclusions A deviation of potassium levels from 3.50 to 4.00 mmol/L, lower sodium levels and hypochloremia were associated with poorer short-term prognosis of ADHF. Furthermore, the number of electrolyte abnormalities positively correlated with adverse short-term prognosis of patients with ADHF. Key Messages ADHF patients with baseline serum potassium at first half part of normal range (3.50–4.00 mmol/L) may herald the lowest risk of recent cardiovascular events. Serum sodium and chloride levels exhibit discrepancies in terms of risk of short-term adverse events of ADHF patients. The number of electrolyte abnormalities is a significant predictor of poor short-term prognosis in patients with ADHF. Clinical trial registration URL http://www.chictr.org.cn/showproj.aspx?proj=23139. Unique identifier: ChiCTR-POC-17014020.

Background and Aims To investigate the relationship between hypochloremia on all-cause death in patients receiving continuous ambulatory peritoneal dialysis (CAPD). Method 300 CAPD patients from January 2013 to December 2019 in the Sixth People's Hospital affiliated to Shanghai Jiaotong University. According to the serum chloride level, the patients were divided into two groups: hypochloremia group (serum chlorine ≤ 96mmol / L, n = 135) and normal chloride group (106mmol / L &amp;lt; serum chlorine &amp;gt; 96mmol / L, n = 165). The endpoint was all-cause death. We used the receiver-operating characteristic (ROC) curve to analysis the diagnostic value and logistic regression to assess the predictive value in relation to serum chloride with all-cause death in CAPD patients. Kaplan Meier curve was used to evaluate the effect of serum chloride on all-cause death survival analysis. All statistics were analyzed by SPSS 20.0 software, P &amp;lt; 0.05, indicating significant difference. Results 114 cases of all-cause death occurred in CAPD patients during follow-up (62.1 ± 11.1 months). The results of correlation analysis showed that serum chloride was positively correlated with serum sodium and potassium (r=0.721,0.199, P=0.001) and the negative correlation between serum chloride and dialysis age and serum phosphorus (r=-0.321, - 0.300, P=0.001). ROC curve analysis showed that serum chloride was statistically significant in predicting all-cause death in CAPD patients (AUC = 0.666, 95% Cl = 0.601-0.730, sensitivity / specificity = 64.6% / 59.8%, best threshold = 95.5mmol/l). Kaplan Meier analysis of all-cause death risk curve shows that the incidence of all-cause death in the low chloride group is higher than that in the normal serum chloride group. Logistic regression analysis showed that low chloride level was an independent risk factor for all-cause death in CAPD patients. Conclusion Hypochloremia is an independent risk factor for all-cause death in CAPD patients.

Objective: The aim of this study is to analyze the interrelationship and pattern of electrolyte imbalance and compare the correlation between serum electrolytes, glycosylated hemoglobin (HbA1C), and hemoglobin (Hb) levels between Type 2 diabetic patients and non-diabetic subjects.Methods: This study was conducted in 300 subjects (150 diabetics and 150 non-diabetics) and further categorized as anemic and non-anemic within each group. Blood samples were analyzed for HbA1C, hemoglobin, and serum electrolyte levels.Results: Sodium (Na+) levels in diabetics were significantly lower and potassium (K+) as well as chloride (Cl−) levels were significantly higher, when compared with non-diabetics. A significant positive correlation between HbA1C and potassium as well as chloride levels in contrast to negative correlation with sodium levels was observed in both genders. Among diabetics with anemia, we found significantly lower sodium and higher potassium and chloride.Conclusion: In diabetics, levels of sodium were significantly lower, and potassium as well as chloride was significantly higher when compared with non-diabetics. Our study clearly demonstrates an association between electrolytes, hemoglobin, and HbA1C levels in diabetes. This insight should pave the way for pathophysiology-directed therapy, thus contributing to the avoidance of several deleterious effects associated with electrolyte disorders and their treatment.

Preventing pseudohyponatremia: Intralipid®-based lipemia cutoffs for sodium are inappropriate