Hypophosphatemia among severely malnourished children with sepsis in <scp>B</scp>angladesh

Yoshimatsu, Shoji; Hossain, Iqbal; Islam, M Munirul; Chisti, Mohammod Jobayer; Okada, Masafumi; Kamoda, Tomohiro; Fukushima, Takashi; Wagatsuma, Yukiko; Sumazaki, Ryo; Ahmed, Tahmeed

doi:10.1111/j.1442-200x.2012.03724.x

Cited by 16 publications

(16 citation statements)

References 21 publications

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“…Shoshimatsu et al, (using standard Dhaka protocol-phosphorous content not known) have reported hypophosphatemia in 14% at discharge. 4 When using premix F100 containing 579 mg phosphorus/L as per new UN specification the prevalence of hypophosphatemia at discharge was 6% as per Namusoke et al 8 This variation could be due to loss of follow up at discharge(40-48%) in both these studies. However, in present study authors have analyzed only those for whom S phosphorous is available at all three points of time.…”

Section: Changes During Treatmentmentioning

confidence: 87%

“…The prevalence of hypophosphatemia at admission in malnourished children has been reported as 86% by Kimutai et al,72.9% by Shoshimatsu et al, 37% by Namusoke et al, respectively. 3,4,8 This variation may be due to differences in dietary intake, cut off limits for hypophosphatemia and laboratory method of estimation.…”

Section: S-phosphate At Admissionmentioning

confidence: 99%

“…Similar fall in mean S phosphate at the end of stabilization phase has been reported by Kimutai et al, shoshimatsu et al, who have used locally prepared diet probably low in phosphorous content (the phosphorous content of which is not revealed in their articles). 3,4 Hence, authors suggest supplementing phosphorous during F75 therapy.…”

Section: Changes During Treatmentmentioning

confidence: 99%

“…Locally prepared F-75 thus provide limited amounts of phosphorous during stabilization, and substantially less than the 60mg/kg/day recommended by WHO. [3][4][5] This combination of a high proportion of energy from carbohydrate and the low phosphorus content may be problematic.…”

Section: Introductionmentioning

confidence: 99%

“…In previous studies, the frequency of hypophosphatemia was found to be 72.9%-93% when SAM children are fed with locally prepared F75 (which contains substantially less phosphate than WHO recommended 60mg/kg/day). [3][4][5] In contrast use of premixed F75 with extra added phosphorous salt as per UN specifications which provides a phosphorous intake of 73mg/kg/d seems to prevent refeeding hypophosphatemia. 6 Hence, authors aimed to know the serum phosphorous level during nutritional rehabilitation of SAM children using locally prepared F75 (containing 35mg/kg of phosphorous).…”

Section: Introductionmentioning

confidence: 99%

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Changes in serum phosphorous level during inpatient treatment of children with severe acute malnutrition

Dakshayani

Divyashree

Sabapathi

et al. 2019

Int J Contemp Pediatr

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Background: SAM children have increased requirements for phosphorus during recovery. If requirements are not met, they may develop refeeding hypophosphatemia leading to increased morbidity and mortality. However, no much studies known about the effect of current therapeutic diets (F-75 and F-100) on serum phosphate in SAM children.Methods: Prospective observational study, in which measuring serum phosphate at admission, at end of stabilization phase and at discharge in SAM children between 6-59 months.Results: Among 35 children enrolled, mean serum phosphate was 4.3 ±0.6 mg/dl at admission, 4.1± 0.8mg/dl at end of stabilization phase and 4.4±0.7mg/dl at discharge. 17% of children had hypophosphatemia at admission, 31% at end of stabilization phase and 17% at discharge. mean weight gain in hypophosphatemia and normophosphatemia groups are 1.3±1.46mg/kg/day and 2.51±2.63mg/kg/day (p=0.1) respectively. Mean duration of stay in hypophosphatemia and normophosphatemia groups are 11.6±1.26 and 10.26±1.54 days respectively (p=0.016).Conclusions: Hypophosphatemia was common among children with SAM at admission and increased at end of stabilization phase. Serum phosphate remains subnormal in about 1/5th of the children at discharge. This could be problematic for further recovery as phosphorus is needed for catch-up growth and bioavailability of phosphorus is low in local diets. Hence, authors suggest phosphorus supplementation in SAM children.

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Section: Changes During Treatmentmentioning

confidence: 87%

Section: S-phosphate At Admissionmentioning

confidence: 99%

Section: Changes During Treatmentmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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