title: Hypophosphatemia among severely malnourished children with sepsis in Bangladesh.
abstract: BACKGROUND
  The interaction between hypophosphatemia (HP) and severe malnutrition has received little attention. This study investigated the prevalence, severity, and risk factors of HP among severely malnourished children with sepsis in Bangladesh.
  
  
  METHODS
  Children aged 6-59 months admitted with sepsis to Dhaka Hospital from April 2010 to December 2011 were enrolled in the study and divided into two groups: severe acute malnutrition (SAM) and non-SAM groups. Plasma phosphate and the related biochemical parameters were measured upon admission and on the second and fourth days for both groups and the 10th day or discharge day for the SAM group.
  
  
  RESULTS
  The prevalence of HP (plasma phosphate <3.7 mg/dL) was 72.9% and 62.5% (P = 0.26) for 48 SAM and for 56 non-SAM patients, respectively; that of moderate-severe HP (phosphate <2 mg/dL) was 25.0% and 19.6%, respectively (P = 0.51). The plasma phosphate level of 21 SAM patients was significantly lower on the second and fourth days than upon admission (P = 0.03, P = 0.01, respectively); it then recovered on the 10th day or discharge day. On multiple logistic regression analysis, plasma potassium <2.5 mmol/L upon admission was found to be a risk factor for moderate or severe HP (adjusted odds ratio, 7.21; 95% confidence interval: 1.88-27.7).
  
  
  CONCLUSIONS
  HP is common among children with sepsis. Potassium <2.5 mmol/L upon admission is considered a risk factor for moderate or severe HP in children with sepsis.
authors.affiliation: Department of Child Health, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan. c0730212@md.tsukuba.ac.jp
authors.forename: Shoji
authors.initials: S
authors.lastname: Yoshimatsu
authors.forename: Md Iqbal
authors.initials: MI
authors.lastname: Hossain
authors.forename: Md Munirul
authors.initials: MM
authors.lastname: Islam
authors.forename: Mohammod Jobayer
authors.initials: MJ
authors.lastname: Chisti
authors.forename: Masafumi
authors.initials: M
authors.lastname: Okada
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Kamoda
authors.forename: Takashi
authors.initials: T
authors.lastname: Fukushima
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Wagatsuma
authors.forename: Ryo
authors.initials: R
authors.lastname: Sumazaki
authors.forename: Tahmeed
authors.initials: T
authors.lastname: Ahmed
mesh_terms: D001459:Bangladesh; D016022:Case-Control Studies; D002675:Child, Preschool; D005260:Female; D006801:Humans; D017674:Hypophosphatemia / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D007223:Infant; D016015:Logistic Models; D008297:Male; D044342:Malnutrition / Q000150:complications* / Q000401:mortality; D016017:Odds Ratio; D015995:Prevalence; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D018805:Sepsis / Q000150:complications* / Q000401:mortality; D012720:Severity of Illness Index