Electrolyte disturbance profiles and associated factors in Somali patients with heart failure

Electrolyte disturbances are frequent yet under-monitored complications of heart failure (HF), contributing to arrhythmias, prolonged hospitalization, and increased mortality. Data from Somalia remain scarce, despite the growing HF burden.

A retrospective cross-sectional study was conducted among 369 adult HF patients admitted to Mogadishu Somali-Turkish Training and Research Hospital between January 2023 and January 2025. Demographic, clinical, and laboratory data were analyzed using IBM SPSS Statistics v29. Electrolyte disturbances were classified by standard cut-offs, and associations with clinical variables were tested using Chi-square and Pearson correlation analyses.

The mean age was 60.1 ± 15.2 years, and 43.6% were female. The mean ejection fraction was 31.3 ± 8.0% (range 10-45%), with most patients having reduced EF. Hyponatremia occurred in 38.5%, hypokalemia in 17.1%, and hypomagnesemia in 16.3%. Among affected patients, severe hyponatremia was most frequent (26.8%), while hypokalemia was largely mild (73.0%). Loop-diuretic therapy was significantly associated with hyponatremia and hypokalemia (P < 0.05), while electrolyte levels showed no significant correlation with age or ejection fraction (|r| ≤ 0.14).

Electrolyte disturbances - particularly hyponatremia and hypokalemia - are highly prevalent among Somali HF patients. These findings highlight the need for improved electrolyte monitoring in HF management in low-resource settings. Strengthening electrolyte monitoring and improving diagnostic capacity are essential for optimizing HF management in low-resource settings.