Objective: Chronic hypokalaemia is a cause of morbidity and mortality. The purpose of this study is to determine the aetiology of chronic hypokalaemia in children at a tertiary care hospital setting.
Methods: Retrospective medical record review of consecutive cases of persistent chronic hypokalaemia of more than three months duration.
Results: There were 51 patients with chronic hypokalaemia. Females were 55%. Mean age was 8 years (range 1 month to 18 years). Metabolic alkalosis, metabolic acidosis were found in 30/51(58.8%), and 19/51(37.2%) respectively. Normal blood pressure was found in 23/30 (76.7%) of patients with metabolic alkalosis. Bartter syndrome was diagnosed in 21 patients. Hypertension was found in 6/30 (20%) patients with metabolic alkalosis. Four had apparent mineralocorticoid excess. Distal renal tubular acidosis (dRTA) was the most common cause in the metabolic acidosis group followed by Fanconi syndrome.
Conclusion: In cases of hypokalaemia, patients may be divided according to the acid base balance. Those with metabolic alkalosis may be divided into those with normal blood pressure and those with hypertension. Focused history, physical examination, especially volume status and spot urinary chloride helps in the differential diagnosis of normotensive cases with metabolic alkalosis.
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