尼日利亚北部卡诺市一家三级医院就诊儿童电解质和肾功能紊乱的负担和严重程度。

Burden and severity of deranged electrolytes and kidney function in children seen in a tertiary hospital in Kano, northern Nigeria.

机构信息

Department of Paediatrics, Aminu Kano Teaching Hospital and Bayero University, Kano, Nigeria.

Department of Paediatrics and Child Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.

出版信息

PLoS One. 2023 Mar 17;18(3):e0283220. doi: 10.1371/journal.pone.0283220. eCollection 2023.

DOI:10.1371/journal.pone.0283220

PMID:36930619

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10022757/

Abstract

INTRODUCTION

Derangement in serum electrolytes and kidney function is often overlooked, especially in resource-constrained settings, and associated with increased risk of morbidity and mortality. This study aimed to describe the burden of derangements in serum electrolytes and kidney function in children presenting to a tertiary hospital in Nigeria.

METHODS

The laboratory records of all children who had serum electrolytes urea and creatinine ordered on their first presentation to hospital between January 1 and June 30, 2017 were retrospectively reviewed. Basic demographic data including admission status (inpatient or outpatient) were recordedandserum levels of sodium, potassium, chloride and bicarbonate were assessed for derangements usingnormal values from established reference ranges. Results of repeat samples were excluded. Kidney function was classified based on the serum creatinine relative to normal values for age and sex.

RESULTS

During the study period, 1909 children (60.3% male); median (IQR) age 42 (11.9) months had serum chemistry and 1248 (65.4%) were admitted. Results of their first samples were analyzed. Electrolyte derangements were present in 78.6% of the samples most commonly hyponatraemia (41.1%), low bicarbonate(37.2%), hypochloraemia (33.5%) and hypokalemia(18.9%). Azotaemia was found in 20.1% of the results. Elevated serum creatinine levels were found in 399 children (24.7%), 24.1% of those being in the severe category. Children aged 5 years and younger accounted for 76.4% of those with derangement in kidney function. One hundred and eight outpatients (17.8%) had deranged kidney function.

CONCLUSION

Deranged serum electrolytes and kidney function were common in this cohort.

摘要

简介

血清电解质和肾功能紊乱在资源有限的情况下经常被忽视，尤其是在资源有限的情况下，这与发病率和死亡率的增加有关。本研究旨在描述在尼日利亚一家三级医院就诊的儿童中血清电解质和肾功能紊乱的负担。

方法

回顾性分析了 2017 年 1 月 1 日至 6 月 30 日期间首次就诊时血清电解质和尿素肌酐医嘱的所有儿童的实验室记录。记录了基本的人口统计学数据，包括入院状态（住院或门诊），并使用既定参考范围的正常值评估了钠、钾、氯和碳酸氢盐的血清水平是否存在紊乱。排除了重复样本的结果。根据血清肌酐相对于年龄和性别的正常值对肾功能进行分类。

结果

在研究期间，有 1909 名儿童（60.3%为男性）；中位数（IQR）年龄 42（11.9）个月进行了血清化学检查，1248 名（65.4%）住院。分析了他们的第一次样本结果。78.6%的样本存在电解质紊乱，最常见的是低钠血症（41.1%）、低碳酸氢盐血症（37.2%）、低氯血症（33.5%）和低钾血症（18.9%）。20.1%的结果发现有氮血症。399 名儿童（24.7%）发现血清肌酐水平升高，其中 24.1%为严重升高。肾功能紊乱的儿童中，年龄在 5 岁及以下的占 76.4%。108 名门诊患儿（17.8%）存在肾功能紊乱。