Serum Electrolyte Profiles of Under‑five Nigerian Children Admitted for Severe Dehydration Due to Acute Diarrhea

Abstract

Background: Serum electrolyte disturbances are common in under‑five children with acute diarrhea but may remain unrecognized, resulting in morbidity and sometimes mortality.
Objective: The objective was to assess the type and prevalence of electrolyte abnormalities in severely dehydrated under‑five children with acute diarrhea at the point of hospital admission.
Patients and Methods: This was a descriptive, hospital‑based cross‑sectional study of children aged 1–59 months with severe dehydration due to acute diarrhea. Serum electrolyte profiles were determined. Outcome measures such as death or survival were recorded. The co‑morbidities were also recorded.
Results: Of the 63 children studied, 50 (79.3%) subjects were aged below 36 months. Vomiting and fever accompanied diarrhea in 33 (52.4%) of the cases. The frequencies of the various types of dehydration were hyponatremic in 41 (65.1%), isonatremic in 17 (27.0%), and hypernatremic in 5 (7.9%) of the children. Of the electrolyte abnormalities observed, hyponatremia and hypokalemia ranked first and second in frequency, respectively. The overall case fatality rate was 6 (9.5%). All the patients that died were aged below 24 months. 5 (83.3%) of the 6 patients that died had a combination of metabolic acidosis in association with one or two other electrolyte abnormalities. 6 (10.5%) of the 57 patients that survived had normal serum electrolyte profiles.
Conclusion: Hyponatremia, hypokalemia, and metabolic acidosis were the leading electrolyte abnormalities in acute diarrheal illnesses and were responsible for most diarrhea‑related deaths, particularly when measles or bronchopneumonia is a co‑morbid condition.