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Early management of hypokalaemia in severely malnourished children under five could help to reduce deaths in developing countries
Author(s) -
Shahid Abu Sadat Mohammad Sayeem Bin,
Alam Tahmina,
Shahrin Lubaba,
Shahunja K. M.,
Sarmin Monira,
Afroze Farzana,
Waliur Rahman Muhammad,
Faruque A. S. G.,
Ahmed Tahmeed,
Chisti Mohammod Jobayer
Publication year - 2021
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/apa.15634
Subject(s) - medicine , hypocalcaemia , lethargy , wasting , pediatrics , malnutrition , metabolic acidosis , hypernatremia , underweight , mortality rate , hyperchloremia , case fatality rate , hyponatremia , intensive care medicine , epidemiology , body mass index , overweight , chemistry , organic chemistry , calcium , sodium
Abstract Aim This study evaluated the factors associated with hypokalaemia and their outcomes, in severely malnourished children under 5 years of age. Methods We focused on 407 severely malnourished children under five who were admitted to the Dhaka Hospital, International Centre for Diarrhoeal Disease Research, Bangladesh, from April 2011 to June 2012. The cases were 139 with hypokalaemia, and the comparisons were 268 without hypokalaemia. Results Cases were older than the comparisons, with a poor socio‐economic status and a higher death rate of 12% vs 7%. They were more likely to present with a history of measles, diarrhoea, lethargy, lower pulse rates, hyponatraemia, metabolic acidosis, hypocalcaemia, hypomagnesaemia, higher height or length, severe underweight, severe wasting and leucocytosis on admission. At discharge, cases had lower potassium levels and a higher proportion had persistent hypokalaemia. Cases received longer treatment with ampicillin and micronutrients. After adjusting for confounders, hypokalaemia was independently associated with poor socio‐economic status, diarrhoea, lower pulse rates, hypocalcaemia, metabolic acidosis and leucocytosis. Conclusion Identifying simple clinical signs, like diarrhoea and lower pulse rates, and laboratory parameters, such as hypocalcaemia and metabolic acidosis, may enable the early management of hypokalaemia in severely malnourished children under 5 years. This could reduce morbidity and mortality.