Chronic kidney disease (CKD) is a complex and multifaceted disease, causing renal dysfunction and progression to end-stage kidney disease (ESKD) and cardiovascular disease. Complications associated with the disease contribute to the acceleration of CKD progression and risk of cardiovascular-related morbidities.^[1] Electrolyte imbalances are major complications of chronic kidney disease (CKD), resulting from the progressive loss of the kidneys' ability to maintain fluid and electrolyte balance. As glomerular filtration rate (GFR) declines, adaptive renal and extrarenal mechanisms attempt to preserve homeostasis, but disturbances in potassium, sodium, phosphate, and magnesium become increasingly common. These imbalances can lead to hyperkalemia, hypokalemia, dysnatremia, hyperphosphatemia, and dysmagnesemia, causing serious cardiovascular, neuromuscular, metabolic, and neurological complications.^[2] Dysnatremia and dysmagnesemia exhibit a U-shaped association with mortality, highlighting the risks of both low and high serum levels. CKD also impairs acid-base regulation, calcium-phosphate metabolism, and erythropoiesis, contributing to metabolic acidosis, mineral bone disorders, and anemia. With CKD projected to become the fifth leading cause of death by 2040, early diagnosis, dietary management, medication optimization, and appropriate therapeutic interventions are essential to restore electrolyte homeostasis, reduce complications, and improve patient outcomes.