Original Research

The spectrum of electrolyte abnormalities in black African people living with human immunodeficiency virus and diabetes mellitus at Edendale Hospital, Pietermaritzburg, South Africa

Preyanka Pillay, Somasundram Pillay, Nobuhle Mchunu
Southern African Journal of HIV Medicine | Vol 21, No 1 | a1095 | DOI: https://doi.org/10.4102/sajhivmed.v21i1.1095 | © 2020 Preyanka Pillay, Somasundram Pillay, Nobuhle Mchunu | This work is licensed under CC Attribution 4.0
Submitted: 26 April 2020 | Published: 23 July 2020

About the author(s)

Preyanka Pillay, Department of Internal Medicine, Greys Hospital, Pietermaritzburg, South Africa; and, School of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
Somasundram Pillay, Department of Internal Medicine, Edendale Hospital, Pietermaritzburg, South Africa; and, Department of Internal Medicine, King Edward Hospital, Durban, South Africa
Nobuhle Mchunu, Department of Biostatistics, Faculty of Statistics, South African Medical Research Council, Durban, South Africa; and, Department of Statistics, School of Mathematics, Statistics and Computer Science, University of KwaZulu-Natal, Pietermaritzburg, South Africa


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Abstract

Background: Serum electrolyte abnormalities in black African people living with human immunodeficiency virus (HIV) and diabetes mellitus (PLWH/DM) is unknown.

Objectives: The aim of this study was to analyse serum electrolytes (sodium, potassium, calcium and phosphate) and factors associated with electrolyte abnormalities in black African PLWH/DM versus HIV-uninfected patients with DM.

Methods: We conducted a retrospective case-control study in 96 black African PLWH/DM (cases) and 192 HIV-uninfected patients with DM (controls), who were visiting the Edendale Hospital DM clinic, from 01 January 2016 to 31 December 2016. Pearson’s correlation, multivariate linear and logistic regression analyses were utilised.

Results: Hypocalcaemia was the most frequent electrolyte abnormality in PLWH/DM and HIV-uninfected patients with DM (31.25% vs. 22.91%), followed by hyponatraemia (18.75% vs. 13.54%). Median (IQR) corrected serum calcium levels were significantly lower in PLWH/DM compared with HIV-uninfected patients with DM (2.24 [2.18–2.30] mmol/L vs. 2.29 [2.20–2.36] mmol/L; p = 0.001). For every per cent increase in glycated haemoglobin, the odds of hyponatraemia significantly increased in both PLWH/DM (odds ratio [OR]: 1.55; 95% confidence interval [CI]: 1.19 –2.02; p = 0.003) and HIV-uninfected patients with DM (OR: 1.26; 95% CI: 1.04 –1.54; p = 0.009).

Conclusion: Hypocalcaemia and hyponatraemia were the most frequent electrolyte abnormalities and occurred more frequently in PLWH/DM compared with HIV-uninfected patients with DM. People living with HIV and DM have significantly lower corrected serum calcium levels compared with HIV-uninfected patients with DM. Furthermore, hyponatraemia is a marker of impaired glycaemic control.


Keywords

HIV; diabetes mellitus; electrolytes; sodium; potassium; calcium; phosphate; black African

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