THE PREVALENCE OF HYPOKALEMIA AND HYPONATREMIA IN INFECTIOUS

DISEASES HOSPITALIZED PATIENTS

Nasronudin
Tropical and Infectious Diseases Division, Department of Internal Medicine
Dr. Soetomo Hospital - Airlangga University School of Medicine

ABSTRACT
Background: Electrolyte disorders is common in hospitalized patients. Hypokalemia
and hyponatremia is the most common electrolyte disorders in hospitalized patients,
especially in tropical and infectious diseases ward. Hypokalemia may result from one
or more: decreased net intake, shift into cells, or increased net loss. The total body
potassium of a normal adult is approximately 40-50 mEq/kg body weight. Only about
1.5 % is present in the ECF. A typical daily potassium intake is 1.0-1.5 mEq/kg body
weight; about 10% of this excreted in the stool and sweat and the remainder by the
kidneys. The normal kidney can excrete up to 6 mEq/kg/day of potassium. Incidence
study of hypokalemia and hyponatremia in hospitalized patients in Indonesia is
reported rarely. Hypokalemia and hyponatremia should be understood because all
medical intervention for treating hypokalemia/hyponatremia is guided by the serum
potassium and sodium levels.
Objective: To disclose the prevalence of hypokalemia and hyponatremia that occurs
in hospitalized patients with infectious diseases.
Patients and Methods: This study used cross sectional study was carried out in the
Tropical and Infectious ward Dr Soetomo Hospital Surabaya, December 2005 to June
2006 period. Observational design with panel study approach. All hospitalized
patients with infectious diseases received maintenance infusion were enrolled in this
study. Since admission and discharge patients we collected the blood sample and
perform the serum potassium and sodium level.
Results: One hundred and ten subjects were enrolled in this study. Fifty (45,5%)
males and sixty (54.5%) females. The age ranged 14 to 80 years old. The most
commonest of the tropical and infectious diseases type were DF/DHF 73 (66.36%),
and than followed by acute diarrhea 27 (24.55%), typhoid fever 3 (2.72%), food
intoxication 3 (2.72%), AIDS 2 (1.85%), malaria 1 (0.9%), pneumonia 1 (0.9%). The
most common maintenance solution type were given ringers acetate or asering (RA)
54 (49.09%), then followed by ringers lactate (RL) 36 (32.73%), KAEN 3B + RA
7(6.36%), NaCl 0.9% 4 (3.68%), RA + RD5 3 (2.72%), RL + D5% 3 (2.72%), KAEN 3B 1
(0.9%), RA + KAEN3B+HES 1(0.9%), RL + D10% 1 (0.9%). Prevalence of hipokalemia,
normokalemia and hyperkalemia among the hospitalized patients on admission is 40

(36.36%), 67 (61%) and 3 (2.54%) patients respectively. During hospiltalization is 56

(50.91%), 50 (45.45%) and 4 (3.64%) patients respectively. Prevalence of
hyponatremia, normonatremia and hypernatremia on admission 49 (44.55%), 57
(51.82%) and 4 (3.63%) patients respectively. During hospitalization 37 (33.82%), 70
(63.64%) and 3 (2.54%) patients respectively.
Conclusion and Recommendation: the prevalence of hypokalemia 40(36.36%) and
hyponatremia 49 (44.55%) on admission and hypokalemia 56 (50.91%) and
hyponatremia 37 (33.82%) during hospiltalization of Tropical and Infectious Diseases
Division ward Departement of Internal Medicine Dr Soetomo Hospiatal, Surabaya.
Based on the results of this study, the author recommendation to conduct further
studies to clarify the effect of RA and KAEN 3B as replacement and maintenance fluid
to potassium and sodium level base on various infectious diseases during
hospitalization.

Keywords: hypokalemia, hyponatremia, prevalence