The Prevalence of Sodium and Potassium Abnormalities in Hospitalized Pediatric Patients of Different Age Groups with Acute Febrile Diarrheal Illnesses: A Single-Center Retrospective Cross-Sectional Study

Abstract

Background: Acute febrile diarrheal illness remains common among infants and children worldwide. Diarrhoeal disease remains a major cause of childhood morbidity and mortality worldwide and is the third leading cause of death among children younger than 5 years. Each year, diarrhea causes approximately 443,832 deaths among children under 5 years of age and an additional 50,851 deaths among children aged 5–9 years. In addition to dehydration, electrolyte abnormalities often accompany diarrheal diseases. In Georgia, cases of childhood gastroenteritis have continued to be reported in recent years, including 2025.

Objectives: To determine the prevalence of sodium (hyponatremia/hypernatremia) and potassium (hypokalemia/hyperkalemia) abnormalities in hospitalized pediatric patients across different age groups, starting from the 29th day of life to 18 years, with acute febrile diarrhea illnesses, and to evaluate the association between electrolyte abnormalities and the severity of dehydration.

Methods: We conducted a single-center retrospective cross-sectional study based on hospital medical records at the Children's Infectious Diseases Clinical Hospital in Tbilisi, Georgia. We included all eligible admissions during 2025, yielding 190 hospitalized children aged 29 days to 18 years with acute febrile diarrhea. We extracted clinical and laboratory data from medical records and analyzed them using descriptive statistics.

Results: The study included 190 hospitalized pediatric patients with acute febrile diarrheal illness. Most patients presented with moderate dehydration and had a short duration of diarrheal illness before hospitalization. We observed electrolyte abnormalities in both sodium and potassium measurements. We found a significant association between potassium abnormalities and age group, but no significant association between electrolyte abnormalities and dehydration severity.

Conclusions: We observed electrolyte abnormalities in hospitalized children with acute febrile diarrheal illnesses, although the prevalence of individual abnormalities was relatively low. We found no statistically significant association between the recorded dehydration category and sodium or potassium abnormalities; however, the small severe-dehydration subgroup limited the precision of this comparison, suggesting that clinical assessment alone may not reliably identify children with electrolyte disturbances.