title: Non-oliguric hyperkalemia in extremely low birth weight infants.
abstract: OBJECTIVE
  It is to examine clinical manifestations, early biochemical indicators, and risk factors for non-oliguric hyperkalemia (NOHK) in extremely low birth weight infants (ELBWI).
  
  
  METHODS
  We collected clinical and biochemical data from 75 ELBWI admitted to Ajou University Hospital between Jan. 2008 and Jun. 2011 by reviewing medical records retrospectively. NOHK was defined as serum potassium≥7 mmol/L during the first 72 hours of life with urine output≥1 mL/kg/h.
  
  
  RESULTS
  NOHK developed in 26.7% (20/75) of ELBWI. Among NOHK developed in ELBWI, 85% (17/20) developed within postnatal (PN) 48 hours, 5% (1/20) experienced cardiac arrhythmia and 20% (4/20) of NOHK infants expired within PN 72 hours. There were statistically significant differences in gestational age, use of antenatal steroid, and serum phosphorous level at PN 24 hours, and serum sodium, calcium, and urea levels at PN 72 hours between NOHK and non-NOHK groups (p-value<0.050). However, there were no statistical differences in the rate of intraventricular hemorrhage, arrhythmia, mortality occurred, methods of fluid therapy, supplementation of amino acid and calcium, frequencies of umbilical artery catheterization and urine output between the two groups.
  
  
  CONCLUSIONS
  NOHK is not a rare complication in ELBWI. It occurs more frequently in ELBWI with younger gestational age and who didn't use antenatal steroid. Furthermore, electrolyte imbalance such as hypernatremia, hypocalcemia and hyperphosphatemia occurred more often in NOHK group within PN 72 hours. Therefore, more use of antenatal steroid and careful control by monitoring electrolyte imbalance should be considered in order to prevent NOHK in ELBWI.
authors.affiliation: Department of Pediatrics, Ajou University School of Medicine, 164 World cup-ro, Yeongtong-gu, Suwon 443-721, Korea.
authors.forename: Jae Ryoung
authors.initials: JR
authors.lastname: Kwak
authors.forename: Myounghoon
authors.initials: M
authors.lastname: Gwon
authors.forename: Jang Hoon
authors.initials: JH
authors.lastname: Lee
authors.forename: Moon Sung
authors.initials: MS
authors.lastname: Park
authors.forename: Sung Hwan
authors.initials: SH
authors.lastname: Kim
mesh_terms: D005865:Gestational Age; D006801:Humans; D006947:Hyperkalemia / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D052577:Infant, Extremely Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D056910:Republic of Korea; D012307:Risk Factors
keywords: Infant; extremely low birth weight; hyperkalemia; infants; premature
references.citation: J Pediatr. 1993 Feb;122(2):276-84
references.pmid: 8381483
references.citation: Eur J Pediatr. 2002 Aug;161(8):415-22
references.pmid: 12172823
references.citation: Pediatr Clin North Am. 1986 Feb;33(1):179-201
references.pmid: 3081865
references.citation: Arch Dis Child. 1988 Jun;63(6):681-2
references.pmid: 3389911
references.citation: Am J Perinatol. 2009 Mar;26(3):185-9
references.pmid: 19031348
references.citation: J Pediatr. 1997 Jul;131(1 Pt 1):81-6
references.pmid: 9255196
references.citation: J Paediatr Child Health. 1990 Feb;26(1):58-61
references.pmid: 2331420
references.citation: Am J Perinatol. 1989 Jan;6(1):76-9
references.pmid: 2910323
references.citation: Am J Perinatol. 2005 May;22(4):211-6
references.pmid: 15906215
references.citation: Pediatrics. 1985 May;75(5):976-86
references.pmid: 3921937
references.citation: Pediatr Int. 2003 Dec;45(6):656-60
references.pmid: 14651536
references.citation: Pediatrics. 1988 Oct;82(4):527-32
references.pmid: 3174313
references.citation: Arch Dis Child. 1989 Feb;64(2):270-2
references.pmid: 2930232
references.citation: J Pediatr. 1978 Apr;92(4):529-34
references.pmid: 305471
references.citation: Dev Pharmacol Ther. 1989;12(3):162-8
references.pmid: 2721338
references.citation: Pediatrics. 1959 Oct;24:562-76
references.pmid: 13840518
references.citation: Indian Pediatr. 2003 Jan;40(1):64-6
references.pmid: 12554924
references.citation: J Pediatr. 1995 Jan;126(1):109-13
references.pmid: 7815197
references.citation: Resuscitation. 2009 Aug;80(8):961
references.pmid: 19477575
references.citation: Pediatrics. 2000 Sep;106(3):561-7
references.pmid: 10969103
references.citation: J Perinatol. 1988 Summer;8(3):211-4
references.pmid: 3066873
references.citation: Z Geburtshilfe Neonatol. 2002 Jan-Feb;206(1):9-14
references.pmid: 11887249
references.citation: J Pediatr. 1988 Aug;113(2):381-6
references.pmid: 3397805
references.citation: Arch Dis Child. 1987 Nov;62(11):1139-43
references.pmid: 3688918
references.citation: Acta Paediatr Taiwan. 2001 Sep-Oct;42(5):282-6
references.pmid: 11729704
references.citation: Clin Perinatol. 2002 Jun;29(2):225-44
references.pmid: 12168239
references.citation: Acta Paediatr Taiwan. 2003 Jul-Aug;44(4):208-14
references.pmid: 14674224
references.citation: Cochrane Database Syst Rev. 2007 Jan 24;(1):CD005257
references.pmid: 17253550
references.citation: Arch Dis Child Fetal Neonatal Ed. 2000 Sep;83(2):F135-8
references.pmid: 10952709
references.citation: Klin Padiatr. 2006 Jan-Feb;218(1):16-9
references.pmid: 16432769