Electrolyte and Acid-Base Abnormalities in Infants with Community-Acquired Acute Pyelonephritis: Prospective Cross-Sectional Study.

Milani, Gregorio P; Grava, Angela; Bianchetti, Mario G; Lava, Sebastiano; Dell''Era, Laura; Teatini, Thomas; Fossali, Emilio F (2017). Electrolyte and Acid-Base Abnormalities in Infants with Community-Acquired Acute Pyelonephritis: Prospective Cross-Sectional Study. Nephron - physiology, 137(2), pp. 99-104. Karger 10.1159/000478054

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BACKGROUND

Retrospective case series suggest that abnormalities in fluid, electrolyte, and acid-base homeostasis may occur among infants with a febrile urinary tract infection. Potentially inaccurate laboratory methods of sodium testing have often been used.

METHODS

Between January 2009 and June 2016, we managed 80 previously healthy infants (52 males and 28 females) ≥4 weeks to ≤24 months of age with their first episode of acute pyelonephritis. Ionized sodium, ionized potassium and ionized chloride were determined by direct potentiometry, as recommended by the International Federation of Clinical Chemistry. Bicarbonate was calculated from pH and carbon dioxide pressure.

RESULTS

Electrolyte or acid-base abnormalities were disclosed in 59 (74%) of the 80 infants: hyponatremia (n = 54), hypobicarbonatemia (n = 18), hyperkalemia (n = 14), hyperbicarbonatemia (n = 6), hypochloremia (n = 3), hypokalemia (n = 3), and hyperchloremia (n = 1). None of the patients was found to be hypernatremic. Patients with and without electrolyte or acid-base abnormalities did not differ with respect to age, sex distribution, and whole blood glucose. Blood tonicity was lower and poor fluid intake, frequent regurgitations or loose stools more common among infants with electrolyte or acid-base abnormalities.

CONCLUSIONS

This prospective cross-sectional study shows that electrolyte or acid-base abnormalities, most frequently hyponatremia, occur in approximately 3 quarters of infants with acute pyelonephritis.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Paediatric Medicine

UniBE Contributor:

Lava, Sebastiano

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1660-2137

Publisher:

Karger

Language:

English

Submitter:

Anette van Dorland

Date Deposited:

28 Mar 2018 16:19

Last Modified:

05 Dec 2022 15:10

Publisher DOI:

10.1159/000478054

PubMed ID:

28697495

Uncontrolled Keywords:

Acidosis Childhood Hyperkalemia Hypokalemia Hyponatremia Pseudohypoaldosteronism

BORIS DOI:

10.7892/boris.111749

URI:

https://boris.unibe.ch/id/eprint/111749

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