Electrolytes and NA(+)-K(+)-ATPase: potential risk factors for the development of diabetic nephropathy

Diabetic nephropathy is the leading cause of death that affects more than 40% of diabetic patients. Its metabolic derangements are frequently accompanied with electrolyte imbalances. This study was aimed to evaluate the electrolyte homeostasis during the progression of diabetic nephropathy in various stages of developing nephropathy. Patients admitted in diabetic wards of various hospitals of Karachi were selected and divided into 4 groups with 50 individuals each. Group I (healthy normotensive, non-diabetics with normal renal functions as control). Group II (diabetic patients with normal blood pressure and renal functions). Group III (diabetic hypertensive patients without renal disease). Group IV (diabetic nephropathy patients with nephropathy). Their fasting blood samples were drawn and analyzed for the estimations of intra erythrocyte and serum electrolytes and NA(+)-K(+)-ATPase activity. Group II patients showed a significant increase in intra erythrocyte sodium, serum potassium and calcium levels where as intra erythrocyte potassium, NA(+)-K(+)-ATPase, serum sodium and magnesium were significantly decreased as compared to control. Group III showed a significant rise in intra erythrocyte sodium levels but intra erythrocyte potassium, NA(+)-K(+)-ATPase, serum sodium, calcium and magnesium were significantly lowered as compared to control. Group IV revealed a significant increase in intra erythrocyte sodium and significant decrease in intra erythrocyte potassium, NA(+)-K(+)-ATPase, serum sodium, calcium and magnesium levels as compared to control. The results suggest the progressive trends in electrolyte abnormalities in diabetes mellitus leading to end stage renal disease along with the abnormality of their chief transport mechanism. It points towards the potentiality of electrolytes disturbances as indicators for the progression of diabetic nephropathy and also beneficial in prognosis and treatment of the disease.