Intracellular Composition and Homeostatic Mechanisms in Severe Chronic Infantile Malnutrition

Frenk, Silvestre; Metcoff, Jack; Gómez, Francisco García; Ramosgalvan, R; Cravioto, J; Antonowicz, Irena

doi:10.1542/peds.20.1.105

Cited by 59 publications

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“…Reference values for infants at 4 and 45 months of age are given in Table 2 to illustrate this point. Muscle electrolyte composition clearly was different in the two nutritional disorders (2,3,6,10,17). In the first biopsy of children with kwashiorkor, muscle water, sodium, and chloride values were greater than normal, and in the second biopsy they fell significantly.…”

Section: Discussionmentioning

confidence: 96%

Muscle Electrolytes in Malnutrition Syndromes of Children

Nichols,

Garza,

Klish

et al. 1983

J. pediatr. gastroenterol. nutr.

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Muscle electrolyte composition has been studied in 10 infants with marasmus and eight children with kwashiorkor. The presence of altered muscle salt and water concentrations was confined in the latter nutritional syndrome. The marasmic infant, with equivalent or more severe nutritional wasting than the child with kwashiorkor, maintained a more normal muscle electrolyte concentration as indicated by a number of criteria. The pathophysiology of the altered muscle composition in kwashiorkor remains unclear; however, it appears to be more specific than due just to a depletion of available fat and muscle stores. Although possible endocrine mechanisms can be postulated to explain the change in muscle chemistry, the existing evidence is inadequate. Clearly, continuing research is warranted.

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Section: Discussionmentioning

confidence: 96%

Muscle Electrolytes in Malnutrition Syndromes of Children

Nichols,

Garza,

Klish

et al. 1983

J. pediatr. gastroenterol. nutr.

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“…With progression to death, these is an even greater shift of water and Na + into cells (22). Patrick (21) not only documented the increased Na + pump activity in kwashiorkor but was able to predict which children were susceptible to sudden death from cardiac failure.…”

Section: Discussionmentioning

confidence: 99%

Potassium Supplementation in Kwashiorkor

Manary,

Brewster

1997

J. pediatr. gastroenterol. nutr.

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Background:Kwashiorkor is an edimatous form of severe malnutrition and is the predominant form of childhood malnutrition in Malawi. Potassium depletion is common and contributes to the high mortality. The aim of this study was to determine if high potassium supplementation improves the outcome of kwashiorkor treatment.Methods:We performed a randomised, double‐blind, placebo‐controlled, clinical trial of high potassium supplementation in 99 children with kwashiorkor. Controls (n = 51) received a standard potassium intake of 4.7 mmol/kg/day. The intervention group (n = 48) received 7.7 mmol/kg/day. All cases (intervention and control groups) were treated in the hospital‐based Nutrition Rehabilitation Center and received a standard treatment regime of mild feeds, mineral and vitamin supplements, and antibiotics.Results:There was no significant difference in length of hospitalization, or time for resolution of oedema between groups. The case‐fatality rate was reduced by 33% in the high potassium intervention group (13/48) compared to controls (21/51). There was a significant reduction in late deaths (13 in controls vs 3 in intervention group; odds ratio 5.3, 95% confidence interval 1.2‐31.0) but no difference in early deaths (0‐5 days). The intervention group also had significantly fewer presumed septic episodes (3 vs 18, odds ratio 8.9, confidence interval 2.2‐50.9), respiratory symptoms, and new skin ulcerations than controls.Conclusions:The high potassium supplementation reduced mortality and significant morbidity in kwashiorkor. This may be due to improved myocardial and immune function from earlier repletion of intracellular potassium. We recommend that the standard potassium supplement for the initial phase of treatment of kwashiorkor be increased from 4 to 8 mmol/kg/day.

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The Significance of Body Size

Darrow¹

1959

Arch Pediatr Adolesc Med

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Intracellular Composition and Homeostatic Mechanisms in Severe Chronic Infantile Malnutrition

Cited by 59 publications

References 0 publications

Muscle Electrolytes in Malnutrition Syndromes of Children

Muscle Electrolytes in Malnutrition Syndromes of Children

Potassium Supplementation in Kwashiorkor

The Significance of Body Size

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