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Sodium balance during acute diarrhoea in malnourished children
Zin-Thet-Khine1, Khin-Maung-U, Myo-Khin
1Department of Medical Research, Ministry of Health, Rangoon, Burma.
Insights
Malnourished children experience greater sodium loss during acute diarrhea, leading to poorer sodium balance. This highlights a critical vulnerability in malnourished children during diarrheal episodes.
Area of Science:
- Pediatric Gastroenterology
- Nutritional Science
- Diarrheal Diseases
Background:
- Acute diarrhea is a significant health concern in children, particularly in malnourished populations.
- Malnutrition can exacerbate the physiological impact of diarrheal diseases.
- Sodium balance is crucial for hydration and overall health during illness.
Purpose of the Study:
- To investigate sodium and potassium balance in malnourished versus normally nourished male children during acute diarrhea.
- To assess the relationship between nutritional status, serum cortisol levels, and sodium balance during diarrheal episodes.
Main Methods:
- Metabolic balance studies and analysis of urine and stool samples over 6-hour periods for up to 48 hours.
- Measurement of serum sodium and potassium levels.
- Radioimmunoassay determination of serum cortisol levels in a subsample.
Main Results:
- Malnourished children exhibited significantly higher sodium loss in stools and urine compared to normally nourished children.
- Diminished gut net sodium balance and total body sodium balance were observed in malnourished children.
- Significantly higher initial serum cortisol levels were found in malnourished children upon admission.
Conclusions:
- Malnourished children demonstrate impaired sodium balance during acute diarrhea, increasing their risk of complications.
- Elevated serum cortisol in malnourished children may indicate a stress response to their compromised nutritional state and diarrheal illness.
Abstract:
Forty-six male children 12-59 months old (27 malnourished and 19 with normal nutrition) admitted for acute water diarrhoea of less than 48 hours' duration were studied. Using a metabolic balance and separate collections of urine and stools over each 6-hour period, balance studies were carried out up to 48 hours. Blood, stool, and urine samples were analysed for sodium and potassium levels. Serum cortisol levels were determined using radio-immunoassay in a subsample of six normal and five malnourished children. Malnourished children lost more sodium in their stools and urine during diarrhoea, so that they had significantly diminished gut net sodium balance and significantly diminished total body sodium balance. Significantly higher levels of serum cortisol were observed initially on admission among children with malnutrition. This study demonstrated that malnourished children had poorer sodium balance during acute diarrhoea.