Clinical Significance of Electrolyte Imbalance in Pediatric Urinary Tract Infection

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+/-6,553/uL vs. 12,885+/-5,367/uL, P<0.05), C-reactive protein (CRP) (61.8+/-56.1 mg/L, vs. 29.9+/-39.8 mg/L, P<0.05), and erythrocyte sedimentation rate (ESR) (43.9+/-34.3 mm/hr vs. 27.4+/-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.