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Category: Volume 07 Issue 09 September 2019
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Title: Electrolyte Disturbances in Children Presenting with Acute Diarrhea: A Prospective Cohort Study

Author: Dr Ajeet Gopchade

 DOI: https://dx.doi.org/10.18535/jmscr/v7i9.136

Abstract

  

Introduction: Acute diarrhea is one of the common causes of hospital admissions in pediatric age group. In developing world diarrheal diseases are cause of a considerable morbidity as well as mortality. Incidence of diarrhea worldwide has remained unchanged and diarrhea related illness and its complications results in millions of visits to pediatricians the mortality has been reduced to considerable levels. One of the common causes of complications in children with diarrhea is electrolyte imbalance which needs to be identified and treated. Hyponatremia and hypokalemia are the common electrolyte imbalances seen in children presenting with acute diarrhea. Though uncommon hypernatremia as well as hyperkalemia can also be seen in these children and needs to be treated so as to prevent complications. This study was undertaken to know the incidence of electrolyte abnormalities in children under the age of 5 years who were admitted with acute diarrhea.

Materials and Methods: This was a prospective cohort study in which 120 children below the age of 5 years and with acute diarrhea were included based on a predefined inclusion and exclusion criteria. Detailed history was taken and clinical examination was done. Stool examination and serum electrolytes were also done in all the cases. Presenting signs and symptoms were analysed. Patients were treated according to institutional protocol. Presence of electrolyte abnormalities were recorded. SSPS 21.0 was used for statistical analysis.

Results: Out of 120 children up to the age of 5 years there were 78 boys (65%) and 42 girls (35%) with a M:F ratio of 1:0.53. The mean age of the affected cases was found to be 2.24 +/- 1.78 years. After loose motion the most common complaint was found to be Abdominal pain which was present in 78 (65%) cases. 78 (65%) children had serum sodium level less than s/o hyponatremia whereas in 41 patients (34.16%) serum sodium was found to be within normal range (135-145 meq/lit). Only 1 patient (0.83%) was found to be having hypernatremia. 21 (17.5%) children had serum potassium level less than 3.5 meq/lit s/o hypokalemia whereas in 99 patients (82.5%) serum potassium was found to be within normal range (3.5-5.5 meq/lit). There was no patient with hyperkalemia in our study.

Conclusion: Electrolyte imbalance is a common occurrence in children presenting with acute diarrhoea and needs to be diagnosed early so as to prevent complications of severe dyselectrolytemia.

Keywords: Acute Diarrhea, Dyselectrolytemia, Hyponatremia, Hypokalemia.

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Corresponding Author

Dr Ajeet Gopchade [MBBS MD]

Consultant Pediatrician, Amrutpath Children Hospital Nanded [MS], India