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Journal of the Korean Society of Pediatric Nephrology 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.
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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
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