Frequency and Pattern of Serum Sodium and Potassium Abnormalities at Point of Hospitalization of Type 1 Diabetic Children with Ketoacidosis: A Retrospective Review from a North-western Nigerian Teaching Hospital
Ugege M. Omoshalewa, Chikani Ugo, Jibrin Baba, Adamu Asmau, Yusuf Tahir, Ibitoye P.Kehinde
Background: Electrolyte abnormalities are often encountered in various illnesses and may be associated with poor prognosis. This study described the frequency and pattern of abnormalities of serum sodium and potassium concentrations in type 1 diabetic (T1D) children with ketoacidosis (DKA) at point of hospitalization in the Emergency Paediatric Unit (EPU) of Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto. Materials and Methods: A retrospective medical records' review was performed on all children diagnosed with type 1 diabetes complicated by DKA in UDUTH, Sokoto over a 15-year period from1st June 2007 to 31st May 2022. The obtained Information included the age, gender, presenting complaints, and treatment outcome (dead or alive). Data on serum electrolyte concentration (sodium, potassium, chloride, bicarbonate) as well as blood glucose before initiation of treatment were extracted. The anion gap and effective osmolality were calculated. Results: Overall, 14 (70.0%) of 20 DKA patients had abnormalities of serum sodium, potassium or a combination of both. Sodium abnormalities occurred in 11(55.0%) patients; Isolated in 5(25.0%) [Hyponatraemia- 4(20.0%), hypernatraemia- 1(5.0%)] and combined [Hyponatraemia with hyperkalaemia] in 6(30.0%) cases. Potassium abnormality occurred in 9(45.0%) patients; isolated hyperkalaemia3(15.0%) and combined [hyperkalaemia with hyponatraemia] - 6(30.0%). The mean ± SD and ranges of blood glucose, anion gap and resolution time of ketoacidosis were 25.31 ± 6.95; 12.3-33.3 mmol/L; 21.60 ± 12.8; 14.50-57.50mmol/L and 1.5 ± 0.6; 1.2-1.8 days. Eleven (55.0%) children were newly diagnosed T1D while 9 (45.0%) were already established diabetics with repeated ketoacidosis. Majority (70%) of the study population were >10 years old. They were managed according to standard protocols. There was no mortality. Conclusion: There is a high frequency of sodium and potassium abnormalities at point of hospitalization in T1D children with DKA; commonest being a combination of hyponatraemia and hyperkalaemia. Keywords: Electrolyte abnormality, ketoacidosis, Type1 diabetes, children, frequency