Clinical features of non-oliguric hyperkalemia in extremely low birth weight infants
GAO Xiao-hui1,2, MAO Jian1
1. The Second Department of Neonatology, Shengjing Hospital of China Medical University, Liaoning, Shenyang 110004, China; 2. Department of Neonatology, Beijing Chaoyang Maternal and Child Hospital, Beijing 100020, China.
Abstract: Objective To investigate the related risk factors, electrolyte characteristics and prognosis of non-oliguric hyperkalemia (NOHK) in extremely low birth weight infants (ELBWI). Methods From March 2012 to March 2015, 91 cases of ELBWI whose birth weight ﹤1 000 g , admitted by the Second Department of Neonatology of Shengjing Hospital of China Medical University were included. They were divided into NOHK group (22 cases), oliguric hyperkalemia group (8 cases) and control group (61 cases) according to the serum potassium levels and urine volume. The level of serum potassium, calcium and intake-output liquid volume were monitored in 24, 48 and 72 h after birth. Basic information, complications, intake-output liquid volume and electrolyte concentration within 72 h after birth, therapeutic measures, conditions of pregnant women and prognosis of three groups were compared. Statistical analysis was performed by variance analysis and χ 2 test. Results The proportion of vaginal delivery of NOHK group was higher than that of control group［63.6% (14/22) vs 21.3% (13/61), P ﹤0.05］. The proportion of polyembryony of NOHK group and oliguric hyperkalemia group were higher than that of control group ［59.1%(13/22) and 87.5% (7/8) vs 27.9% (17/61), P ﹤0.05］. Gestational age of NOHK group, oliguric hyperkalemia group and control group were (27.6±1.6), ( 27.7±1.0) and (28.7±1.7) weeks respectively; 5-minute-Apgar score were (7.8±1.3), (7.5±1.3) and (8.4±0.9) respectively; the above two indicators of NOHK group and oliguric hyperkalemia group were lower than those of control group (both P ﹤0.05). The proportion of crush injury of oliguric hyperkalemia group and control group were 37.5% (3/8) and 4.9% (3/61); rate of blood transfusion were 87.5% (7/8) and 33.9% (7/61); the above two indicators of oliguric hyperkalemia group were higher than those of control group (both P ﹤0.05). There were no statistically significant differences for the proportion of occurrence of asphyxia, acidosis, intrauterine infectious pneumonia and patent ductus arteriosus of three groups (P﹥0.05). And there were also no statistically significant differences for the rate of occurrence of brain injury, necrotizing enterocolitis (NEC), retinopathy of prematurity (ROP), pulmonary disease and death of three groups (P﹥0.05). Conclusions NOHK is related to developmental immaturity of premature.There are no difference of the level of serum potassium and prognosis between NOHK and oliguric hyperkalemia patients. But the level of serum potassium of ELBWI should be monitored and hyperkalemia should be treated regardless of oliguria.
2017, Vol. 5 
