Clinical Significance of Electrolyte Imbalance in Pediatric Urinary Tract Infection

Cho, Sea-Eun; Choi, Lim; Yim, Hyung-Eun; Yoo, Kee-Hwan; Hong, Young-Sook; Lee, Joo-Won

doi:2011.15.1.58

J Korean Soc Pediatr Nephrol > Volume 15(1); 2011 > Article

J Korean Soc Pediatr Nephrol 2011;15(1): 58-65. doi: https://doi.org/10.3339/jkspn.2011.15.1.58

요로감염과 동반된 전해질 불균형의 임상적 의의

조세은, 최림, 임형은, 유기환, 홍영숙, 이주원

¹고려대학교 의과대학 소아과학교실
²고려대학교 의과대학 소아과학교실
³고려대학교 의과대학 소아과학교실
⁴고려대학교 의과대학 소아과학교실
⁵고려대학교 의과대학 소아과학교실
⁶고려대학교 의과대학 소아과학교실

Clinical Significance of Electrolyte Imbalance in Pediatric Urinary Tract Infection

Sea-Eun Cho, Lim Choi, Hyung-Eun Yim, Kee-Hwan Yoo, Young-Sook Hong, Joo-Won Lee

¹Department of Pediatrics, Guro Hospital, Korea University
²Department of Pediatrics, Guro Hospital, Korea University
³Department of Pediatrics, Guro Hospital, Korea University
⁴Department of Pediatrics, Guro Hospital, Korea University
⁵Department of Pediatrics, Guro Hospital, Korea University
⁶Department of Pediatrics, Guro Hospital, Korea University

Received: March 15, 2011; Accepted: April 20, 2011.

ABSTRACT

Purpose: Some hormonal and electrolyte abnormalities have been reported in pediatric patients with urinary tract infection (UTI). This study aimed to investigate the relationships between the imbalance of electrolytes and the severity of infection and associated urologic anomalies in children with febrile UTI.
Methods: We retrospectively reviewed 267 patients with febrile UTI who were admitted to Korea University Guro Hospital during the period from January, 2007 until February, 2010. According to the presence of hyponatremia or hyperkalemia, clinical parameters and associated renal anomalies, such as hydronephrosis, cortical defects and vesicoureteral reflux, were compared.
Results : 42.7% of all patients had decreased concentration of serum sodium. In patients with decreased concentration of serum sodium, cortical defects were significantly increased compared to normal patients (40.4% vs. 14.4%, P <0.05). White blood cell (WBC) counts ($15,721{pm}6,553/uL$ vs. $12,885{pm}5,367/uL$, P <0.05), C-reactive protein (CRP) ($61.8{pm}56.1$ mg/L, vs. $29.9{pm}39.8$ mg/L, P <0.05), and erythrocyte sedimentation rate (ESR) ($43.9{pm}34.3$ mm/hr vs. $27.4{pm}26.8$ mm/hr, P <0.05) in peripheral blood showed significant increases in the group with decreased concentration of serum sodium. Duration of fever, presence of gastrointestinal symptom, the incidence of hydronephrosis and vesicoureteral reflux did not differ between the two groups. None of the patients had significant hyperkalemia.
Conclusion : We suggest that decreased concentration of serum sodium in febrile UTI might be a helpful marker for leukocytosis and increased CRP and ESR in peripheral blood, and acute pyelonephritis.

Key words: Urinary tract infection | Electrolyte imbalance