Electrolyte Imbalances in Cholera: Focusing on Hypokalemic Patterns and Renal Complications

Raoof, Abdullah Adil; Tarab, Mohammed Khaleel

doi:10.32894/kjms.2026.170245.1322

	Electrolyte Imbalances in Cholera: Focusing on Hypokalemic Patterns and Renal Complications
Kirkuk Journal of Medical Sciences
Volume 14, Issue 1, January 2026, Pages 64-71 PDF (602.77 K)
Document Type: Original research
DOI: 10.32894/kjms.2026.170245.1322
Authors
Abdullah Adil Raoof¹; Mohammed Khaleel Tarab^* ²
¹Department of Internal Medicine, College of Medicine, University of Kirkuk, Kirkuk, Iraq
²Department of Clinical Pharmacology, College of Medicine, University of Kirkuk, Kirkuk, Iraq
Abstract
Background: Cholera causes severe diarrhea, which may precipitate hypokalemia, dysnatremia, and acute kidney injury. This study aimed to evaluate the incidence, severity, and associated clinical factors of cholera-related electrolyte disturbances, focusing on hypokalemia and renal complications. Methods: This prospective, multicenter, hospital-based observational study included 166 patients with Vibrio cholerae infection, aged 15–80 years, admitted to Azadi and Kirkuk General hospitals in Iraq between April and October 2022. The study included 67 females and 99 males. Medical history was obtained from all patients. Among the 154 patients with hypokalemia, diarrhea was categorized as mild in 61 patients (39.6%), moderate in 65 (42.2%), and severe in 28 (18.2%). Twelve patients had normal serum potassium levels and were not included in the hypokalemia-specific analyses. Serum potassium, sodium, and chloride levels were measured. Hypokalemia was defined as mild (3.0–3.5mmol/L), moderate (2.5–3.0 mmol/L), or severe (<2.5 mmol/L). Acute kidney injury was diagnosed according to the KDIGO guideline. Results: Among patients with hypokalemia, 50 (32.5%) had mild, 34 (22.1%) had moderate, and 70 (45.5%) had severe hypokalemia. Severe hypokalemia was observed in 17 of 28 diabetic patients (60.7%) and represented the largest hypokalemia category among hypertensive patients, occurring in 25 of 58 patients (43.1%). Moderate hypokalemia was present in 11 of 26 patients with kidney stones (42.3%), while mild and moderate hypokalemia were each observed in 4 of 11 patients with chronic kidney disease (36.4% each). Diarrhea severity and vomiting were significantly associated with hypokalemia severity. Acute kidney injury developed in 21 patients (12.7%), and 11 patients (6.6%) required hemodialysis. Six deaths were recorded, corresponding to a mortality rate of 3.6%. Conclusion: Cholera was associated with clinically important electrolyte disturbances, particularly hypokalemia. Hypokalemia severity was related to diarrhea severity, vomiting status, and lower serum sodium and chloride levels. Early electrolyte correction and renal monitoring are important in hospitalized cholera patients.
Keywords
Cholera; Vibrio cholerae; Hypokalemia; Electrolyte imbalance; Acute kidney injury; Dehydration

Statistics Article View: 44 PDF Download: 51