Chronic renal failure can lead to which of the following electrolyte imbalances?

Chronic renal failure, also known as chronic kidney disease (CKD), significantly impairs the kidneys' ability to excrete waste products and maintain electrolyte balance. One of the hallmark electrolyte disturbances seen in chronic renal failure is hyperkalemia, which is an elevated level of potassium in the blood.

In healthy kidneys, potassium is efficiently excreted in response to dietary intake and hormonal regulation (primarily by aldosterone). However, in chronic renal failure, the kidneys lose their ability to filter and excrete potassium effectively. As a result, potassium levels can rise, leading to hyperkalemia. This condition is serious because excess potassium can cause cardiac abnormalities, including arrhythmias.

The other electrolyte imbalances mentioned may occur in different clinical scenarios or under specific circumstances. However, hyperkalemia is the most common and concerning imbalance associated directly with chronic renal failure due to the kidneys' decreased ability to remove potassium from the body.