Electrolyte Imbalances in Newly Diagnosed Pulmonary Tuberculosis Patients and Reversibility with Treatment

Abstract

Background: Electrolyte imbalances are commonly observed in pulmonary tuberculosis patients but remain under-reported in clinical practice. These disturbancesinvolving sodium, potassium, chloride and bicarbonate - can exacerbate disease severity and delay recovery. Objectives: To evaluate the prevalence, pattern and reversibility of serum electrolyte disturbances in newly diagnosed pulmonary tuberculosis patients compared to healthy controls at a tertiary care hospital in India. Methodology: This observational study enrolled 250 newly diagnosed pulmonary tuberculosis patients and 50 age- and sex-matched healthy controls. Serum sodium, potassium, chloride and bicarbonate levels were measured at baseline using standardized methods. A subset of 100 tuberculosis patients was re-evaluated after four months of antitubercular therapy. Data analysis was performed using SPSS v28.0; p-values <0.05 were considered statistically significant. Results: Tuberculosis patients had significantly lower levels of sodium (127.7 ± 3.9 vs. 140.4 ± 3.3 mmol/L), potassium (3.6 ± 0.7 vs. 4.2 ± 0.5 mmol/L), and chloride (99.8 ± 7.6 vs. 101.9 ± 6.1 mmol/L) than controls (p<0.001). Hyponatremia affected 48.8% of tuberculosis patients, hypokalemia 34.4%, and hypocarbonemia 36.0%. Post-treatment, sodium and potassium levels normalized significantly (p<0.001) and indicated reversibility. Conclusion: Electrolyte imbalances – such as hyponatremia and hypokalemia - were common in tuberculosis patients and showed significant improvement with treatment. Routine electrolyte monitoring should be integrated into tuberculosis care to reduce complications and improve outcomes.