HTML ISSUE

VOLUME 1 ISSUE 2 OCT- DEC 2025

Disorders of Electrolytes and Acid-Base Homeostasis as Precursors to Chronic Kidney Disease: A Phenotypic Clustering Study in a Rural Indian Population

Raghvendra Saini, Swati Soni, B.Jahnavi, Vaishali Rastogi, Ruhi Charak

Background: Imbalances in electrolytes and acid-base status are recognized early indicators of renal impairment, a relationship of critical importance in low-resource rural communities. This investigation assesses key serum parameters, a derived Electrolyte Ratio Index (ERI), and patient categorization via clustering methods within a rural Indian demographic.

Methods: A total of 200 adults were enrolled in this cross-sectional analysis. Concentrations of serum electrolytes, uric acid, calcium, and creatinine were quantified, with the estimated glomerular filtration rate (eGFR) derived. Analyses were performed on a Vitros 4600 platform. The Electrolyte Ratio Index was computed as (Na⁺ + K⁺ + Cl⁻)/HCO₃⁻. Statistical evaluation employed Pearson correlation, sensitivity-specificity assessment, and k-means clustering.

Results: Commonly observed disturbances included hyponatremia (14.0%), hyperkalaemia (17.5%), reduced bicarbonate (15.0%), and hyperuricemia (22.0%). Bicarbonate concentration demonstrated a significant inverse correlation with serum creatinine (r = -0.47, p < 0.001). An ERI value of ≥15 was associated with a diminished mean eGFR (54.7 ml/min), exhibiting a sensitivity of 60%, specificity of 90%, and a Youden Index of 0.50. Cluster analysis delineated three unique biochemical phenotypes, one of which represented a high-risk renal profile.

Conclusion: Electrolyte and acid-base derangements show a strong association with declining renal function. The ERI and cluster-based phenotyping present viable, economical strategies for the early stratification of chronic kidney disease risk in settings with limited healthcare resources.

Keywords: Electrolyte Ratio Index, Chronic Kidney Disease, Estimated Glomerular Filtration Rate, Phenotypic Clustering, Renal Risk Assessment.

Abstract| Download PDF| Current Issue