Early Onset Hyperkalemia in Very Low Birth Weight Infants.

Kim,  Mi Jeong; Yi,  Hye Ryoung; Kim,  Soo Young; Song,  Eun Song; Park,  Chun Hak; Choi,  Young Youn

Original Article

Journal of the Korean Society of Neonatology 2006;13(2):252-260.
Published online November 1, 2006.

Early Onset Hyperkalemia in Very Low Birth Weight Infants.

Mi Jeong Kim, Hye Ryoung Yi, Soo Young Kim, Eun Song Song, Chun Hak Park, Young Youn Choi

¹Department of Pediatrics, Chonnam National University, Gwang Ju, Korea. yychoi@chonnam.ac.kr
²Department of Pediatrics, Seonam University Medical School, Gwang Ju, Korea.

극소 저출생 체중아에서의 조발형 고칼륨혈증

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Abstract

PURPOSE
This study was designed to know the clinical significance and risk factors of hyperkalemia in very low birth weight infants (VLBWI).
METHODS
We compared the incidence of hyperkalemia and its associated ECG abnormalities and mortality rate according to birth weight (102 of less than 1,000 g vs. 328 of 1,000 to 1,500 g) in 430 VLBWI who were born from Jan. 2000 to July 2004, retrospectively, and also compared the several parameter according to serum potassium (35 of hyperkalemia vs. 11 of normokalemia) in 49 selected VLBWI who need mechanical ventilation for respiratory distress without oliguria within 72 hours of life to know the risk factors of hyperkalemia.
RESULTS
Overall incidence of hyperkalemia in VLBWI was 21.1%, and was significantly higher in below 1,000 g than in 1,000 to 1,500 g (32.4% vs. 17.7%, P<0.05). Hyperkalemia associated ECG abnormalities, life-threatening cardiac arrhythmia, and death were also significantly higher in below 1,000 g. There were no significant differences in maternal or infant's characteristics, laboratory findings and clinical conditions between hyperkalemic vs. normokalemic group. The incidence of cardiac arrhythmia and mortality rate were also significantly higher in hyperkalemic group.
CONCLUSION
Early onset nonoliguric hyperkalemia is often associated with life- threatening cardiac arrhythmia and death in VLBWI, especially less than 1,000 g. Although perinatal risk factors were not found in this study, prospective study is needed to establish the preventive strategy and to improve the outcome.

Key Words: Nonoliguric hyperkalemia; Very low birth weight infant; Arrythmia