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Serum calcium and phosphate disturbances during rehydration in acute dehydrating gastroenteritis
D Mohanlal1, J M Pettifor, G P Moodley
1Department of Pediatrics, University of the Witwatersrand, Bertsham, South Africa.
Insights
Serum ionized calcium levels in children with dehydrating gastroenteritis did not drop significantly enough to cause symptoms. However, serum phosphate levels showed notable fluctuations requiring further investigation.
Area of Science:
- Pediatrics
- Biochemistry
- Clinical Nutrition
Background:
- Dehydrating gastroenteritis can disrupt electrolyte balance.
- Understanding mineral and acid-base status is crucial during rehydration therapy.
Purpose of the Study:
- To investigate alterations in serum calcium, magnesium, and phosphate during recovery from acute dehydrating gastroenteritis in children.
- To assess the clinical significance of these electrolyte changes.
Main Methods:
- Serum levels of ionized/total calcium, magnesium, phosphate, and other electrolytes were measured in 15 children.
- Measurements were taken during rehydration and up to 72 hours postadmission.
- Acid-base status and albumin levels were also evaluated.
Main Results:
- Total serum calcium (albumin-corrected) remained within normal limits.
- Serum ionized calcium decreased significantly at 24 and 72 hours but did not cause symptomatic hypocalcemia.
- Serum ionized calcium correlated with pH, bicarbonate, and albumin.
- Serum magnesium levels were normal throughout the study.
- Serum phosphate was elevated on admission, decreased by 12 hours, then gradually increased.
Conclusions:
- Changes in serum ionized calcium during recovery from dehydrating gastroenteritis are unlikely to be clinically significant.
- The dynamic changes in serum phosphate warrant further investigation.
Abstract:
Alterations in serum ionized and total calcium, magnesium, and phosphate concentrations, during recovery from acute dehydrating gastroenteritis, were studied. Fifteen children with acute dehydrating gastroenteritis had serum concentrations of ionized and total calcium, magnesium, phosphate, sodium, potassium, chloride, urea, creatinine, and albumin, as well as acid-base status, evaluated during rehydration and up to 72-h postadmission. The total serum calcium corrected for albumin did not change significantly during rehydration and remained within the normal range. Although serum ionized calcium fell significantly at 24 and 72 h, its concentration was not sufficiently decreased to cause symptomatic hypocalcemia. Serum ionized calcium correlated significantly with pH (r = -0.57), bicarbonate (r = -0.63), and albumin (r = +0.65), but not with total serum calcium, magnesium, and phosphate. Serum magnesium remained within the normal range during the study period. Serum phosphate was increased on admission (2.64 +/- 0.77 mmol/L), decreased by 12 h (to 0.84 +/- 0.32 mmol/L), and then followed by a gradual increase. This study suggests that changes in serum ionized calcium in dehydrating gastroenteritis are not of clinical significance. However, changes in serum phosphate concentration need further evaluation.