Electrolyte and acid-base imbalances and kidney function in children with acute diarrhea: A study from Dr. Soetomo General Academic Hospital 2021–2023
Abstract
Diarrhea is the third leading cause of death in children under five, causing nutritional deficits that hinder growth, cognitive, and academic performance. Each episode before the age of 2 years increases the risk of stunting by 5%. Systematic data, such as sociodemographic, clinical characteristics, and laboratory characteristics, are important for prevention. This descriptive observational study used a retrospective design based on medical records of children with acute diarrhea treated at Dr. Soetomo General Hospital, Surabaya, from 2021 to 2023. A total of 461 subjects met the criteria; 429 underwent electrolyte imbalance testing, 198 were assessed for urea and creatinine levels, and 68 had their acid-base balance evaluated. A total of 288 subjects (62.5%) were male children; 262 patients (75%) were 0-12 months old; 253 (61%) had good nutritional status; 339 (73.5%) underwent therapy for less than 1 week; and 402 patients (65%) recovered. A total of 40% experienced mild-moderate and severe dehydration with neurologic (16.4%) and respiration comorbidities (16.2%). Electrolyte disturbances included hyponatremia (33.1%), hypokalemia (12.1%), hyperchloremia (50.2%), increased urea (28.3%), abnormal creatinine (35.4%), hypobicarbonate (75%), and acidosis (63.2%). Therefore, early detection and appropriate management are essential to mitigate further complications and improve recovery outcomes.
Full text article
References
Adiba, A. F., Soedarmo, S. M., Sulistiawati, S., & Athiyyah, A. F. (2022). Acute Diarrhea Patients among Children Under Five Hospitalized in a Tertiary Hospital in East Java, Indonesia. Folia Medica Indonesiana, 58(1), 33–38. https://doi.org/10.20473/fmi.v58i1.31423
Arif, M., Saleem Afridi, A., Ali, F., Abrar Banuri, S. U., Salman, M., & Khan, M. (2021). Frequency of Hyponatremia and Hypokalemia in Children with Acute Diarrhea. Pakistan Journal of Medical and Health Sciences, 15(9), 2565–2567. https://doi.org/10.53350/pjmhs211592565
Aulia Najma Adhyana Kurniawan, Dwi Aprilawati, Dwiyanti Puspitasari, & Alpha Fardah Athiyyah. (2025). Risk factors of mortality on diarrhea children under five years old hospitalized in Dr. Soetomo General Academic Hospital Surabaya 2023. World Journal of Advanced Research and Reviews, 26(1), 2752–2757. https://doi.org/10.30574/wjarr.2025.26.1.1391
Badan Pusat Statistik Provinsi Jawa Timur. (2022). Badan Pusat Statistik Provinsi Jawa Timur. Retrieved from Badan Pusat Statistik Provinsi Jawa Timur website: https://jatim.bps.go.id/id
Crawford, S. E., Ramani, S., Tate, J. E., Parashar, U. D., Svensson, L., Hagbom, M., … Estes, M. K. (2017). Rotavirus infection. Nature Reviews. Disease Primers, 3(3), 17083. https://doi.org/10.1038/nrdp.2017.83
Edelu, B., Eke, C., Ndu, I., Uleanya, N., Ekwochi, U., Chinawa, J., … Ikefuna, A. (2020). Clinical profile and electrolyte abnormalities in hospitalized under-five children with acute gastroenteritis in a tertiary health facility. Nigerian Journal of Medicine, 29(2), 295. https://doi.org/10.4103/njm.njm_64_20
Ezinwa Olekaibenma Ezuruike, Chikaodili Adaeze Ibeneme, & Uwaezuoke, S. N. (2022). Dyselectrolytemia in under-five children with acute diarrhoea-induced dehydration: a cross-sectional study in a South-East Nigerian hospital. International Journal of Contemporary Pediatrics, 9(11), 1006–1006. https://doi.org/10.18203/2349-3291.ijcp20222759
Fountain, J. H., Lappin, S. L., & Kaur, J. (2023, March 12). Physiology, Renin Angiotensin System. Retrieved from National Library of Medicine website: https://www.ncbi.nlm.nih.gov/books/NBK470410/
Ibrahim, P. F., Umboh, V., & Manoppo, J. I. C. (2024). Gambaran Fungsi Ginjal pada Anak Penderita Diare dengan Dehidrasi di RSUP Prof. Dr. R. D. Kandou Manado. Medical Scope Journal, 6(2), 289–295. https://doi.org/10.35790/msj.v6i2.53577
Jordan, N., Ranuh, I. G. M. R. G., & Sari, G. M. (2020). Profile of Diarrheal Patients Aged Less than Five Years Old Hospitalized in Dr. Soetomo General Hospital Surabaya in 2016-2018. JUXTA: Jurnal Ilmiah Mahasiswa Kedokteran Universitas Airlangga, 11(2), 45. https://doi.org/10.20473/juxta.v11i22020.45-50
Joseph, D., & Sunilbala Keithellakpam. (2023). A study of serum electrolyte imbalances and its impact in children of 4 months to 5 years of age group presenting with acute gastroenteritis. International Journal of Contemporary Pediatrics, 10(2), 221–226. https://doi.org/10.18203/2349-3291.ijcp20230088
Kumar, S. S. V., & Chakravarthi, G. K. (2019). Study on Renal Function in Acute Diarrheal Disease with Dehydration. Asian Journal of Clinical Pediatrics and Neonatology, 7(3), 24–27. https://doi.org/10.21276/ajcpn.2019.7.3.7
Marie Soudre, F., Karfo, R., Kiba, A., Kouraogo, A., Sougue, R., Kabre, E., & Sakande, J. (2023). Serum Electrolytes Profile During Accidental Acute Poisoning in Children at Charles De Gaulle Pediatric University Hospital of Ouagadougou. Advances in Biochemistry. https://doi.org/10.11648/j.ab.20231102.11
Nazia Rehana, Azizullah Langah, Jamali, A. A., Habibullah Siyal, Jamali, A. N., Memon, F. R., & Ahmer, A. (2022). Acute Diarrhea: Risk Factors and Electrolytes Disturbances in Children of Age 2 Months to 5 Years. Journal of Pharmaceutical Research International, 34–41. https://doi.org/10.9734/jpri/2022/v34i30b36077
Nemeth, V., & Pfleghaar, N. (2022, November 21). Diarrhea. Retrieved from PubMed website: https://www.ncbi.nlm.nih.gov/books/NBK448082/
Scott, J. H., Dunn, R. J., & Menouar, M. A. (2023, May 1). Physiology, Aldosterone. Retrieved from PubMed website: https://www.ncbi.nlm.nih.gov/books/NBK470339/
Shankar, P., Mahamud, S., & C. A., A. A. (2020). Study of electrolyte disturbances and renal parameters in acute gastroenteritis under 5 years of age in a tertiary care hospital of Bengaluru, India. International Journal of Contemporary Pediatrics, 7(9), 1910. https://doi.org/10.18203/2349-3291.ijcp20203654
Sharma, S., Hashmi, M. F., & Aggarwal, S. (2022). Hyperchloremic Acidosis. Retrieved from PubMed website: https://www.ncbi.nlm.nih.gov/books/NBK482340
Suparmi Suparmi, Sasman, M. F., Ratnawati Ratnawati, & Ninik Rustanti. (2025). Hygiene and food safety practices among mothers as predictors of diarrhea risk in toddlers in Purwawinangun Village, West Java, Indonesia. Frontiers in Public Health, 13. https://doi.org/10.3389/fpubh.2025.1530828
World Health Organization. (2024, March 7). Diarrhoeal Disease. Retrieved from Who.int website: https://www.who.int/news-room/fact-sheets/detail/diarrhoeal-disease
Authors
Copyright (c) 2026 Arshq Mirza Hamzah, Alpha Fardah Athiyyah, Ulfa Kholili, Sulistiwati Sulistiawati
This work is licensed under a Creative Commons Attribution 4.0 International License.
Qanun Medika by FK UM Surabaya is liscence under Lisensi Creative Commons Atribusi 4.0 Internasional.