ISSN - 0973-0958
GS Shah1, BK Das1, S Kumar1, MK Singh1, GP Bhandari2.
1Department of Pediatrics, 2Community Medicine.

Objective: The present study was undertaken to study the frequency of electrolyte imbalance in children with diarrhea and the relationship between electrolyte abnormalities and mortality.

Materials and methods: This is a retrospective, observational hospital based study. Fifty seven children admitted to pediatric ward with diarrhea and dehydration was evaluated for electrolyte and acid base status at presentation. The variables were analyzed using Chi-square and Student's t-test.

Results: Majority (70%) of patients were below 2 years of age. There were 37 (65%) males and 20(35%) females. The major electrolyte disturbances noted were hyponatremia (56%), which was either isolated (26%) or associated with hypokalemia (26%). The second common abnormality was hypokalemia (46%) which was again either isolated (14%) or associated with hyponatremia (26%). About 10% patient had hypernatremia and about 3% had hyperkalemia. Twenty one (37 %) patients had mixed electrolyte imbalance. ABG analysis was performed only in 16 patients. Metabolic acidosis was present in 15 patients (94%) while one (6%) patient had metabolic alkalosis. Out of 57, five patients (8.7%) expired. All of them had electrolyte abnormalities. Out of five patients who died one had isolated hyponatremia, 2 had hyponatremia + hypokalemia, while one each had hypernatremia + hypokalemia and hypernatremia + hyperkalemia. Statistically significant mortality was observed in patients presenting with either hyponatremia or hypokalemia as compared to the group with normal electrolytes.

Conclusion: Hyponatremia, hypokalemia and metabolic acidosis are common electrolyte and acid-base abnormalities in children with diarrhea and dehydration and often responsible for mortality.
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