Study of serum electrolytes with different clinical co-morbidities in complicated severe acute malnutrition children aged 6 months to 5 years
Keywords:Co-morbidities, Dyselectrolytemia, Potassium, Severe acute malnutrition, Sodium
Background: Severe acute malnutrition (SAM) is one of the most common health problem. SAM children are more prone to severe infections that culminates into different co-morbid conditions and consequentially leads to electrolyte derangements. Hence this study aims to find out the incidence of dyselectrolytemia (Na+ and K+) in malnourished children with different clinical co-morbid conditions.
Methods: It was a hospital based prospective, case-control study conducted on 100 children of complicated as study group and 50 children of uncomplicated SAM as control group, over a period of six months in year 2016. The children included as per WHO reference criteria of SAM in 6 months to 5-years age group. All the enrolled children were assessed with detailed clinical examination according to different co-morbidities, including anthropometry and routine investigations along with serum electrolytes (Na+ and K+) and chest x-ray.
Results: In our study, out of 100 complicated SAM children, dyselectrolytemia was present in 94.0% children. The SAM children with most co-morbidities had subnormal sodium ranging from 128-135 mEq/L while potassium was normal ranging from 3.68-4.34 mEq/L at the time of admission. We observed that mean sodium level was 131.82±6.66 mEq/L while mean potassium level was 4.17±1.03 mEq/L in complicated SAM children. In control group children mean sodium level was 135.90±4.26 mEq/L while mean potassium level was 4.14±1.11 mEq/L.
Conclusions: To conclude that dyselectrolytemia is high in complicated SAM and it is mainly sodium disturbances in the form of hyponatremia in different co-morbid conditions. Hence, we recommend that due care is to be given for management of dyselectrolytemia in complicated SAM children.
Sachdev HPS, Kapil U and Sheila V. Consensus Statement: national consensus workshop on management of SAM Children through medical nutrition therapy. Indian Pediatrics. 2010;47:651-4.
International Institute for population sciences. National family health survey 4. Mumbai India: International Institute of Population Science. 2016.
Black RE, Allen LH, Bhutta ZA, de Onis M, Ezzati M, Mathers C, et al. Maternal and Child undernutrition: global and regional exposures and health consequences. Lancet. 2008;371(9608):243-60
Müller O, Krawinkel M. Malnutrition and health in developing countries. Can Med Assoc J. 2005;173:3.
Inpatient Care Training Materials | Module 2. Principles of Care |FANATA-2. Government of Sudan. 2011:24.
Gangaraj S, Das G, Madhulata S. Electrolytes and blood Sugar Changes in Severely Acute Malnourished Children and Its Association with Diarrhea and Vomiting. Int J Pharm Sci Invent. 2013;2(5):33-6.
Zogg CK, Ahmed T, Faruqur ASG, Das SK, Imran G, Chisti MJ. Predictive Factors of Hyponatremia in Under-Five Severely Malnourished Children with Pneumonia. Food Nutr Sci. 2013;4:398-404.
Akhter S, Alauddin M, Rahman MA, Chowdhury MA. Effect of Protein Energy Malnutrition on the Diarrheal Electrolyte Imbalance in Children of Chittagong Region, Bangladesh. Ind J Nutr. 2014;1(1):101.