Hypo-phosphataemia in children under five years with kwashiorkor and marasmic kwashiorkor

Background: Severe malnutrition contributes up to 50% of childhood mortality in developing countries is frequently characterised by electrolyte depletion, including low total body phosphate. During therapeutic re-feeding, electrolyte shift from extracellular to intra-cellular compartments may induce hypo-phosphataemia (hypo-P) with resultant increased morbidity and mortality. This biochemical imbalance isunder-recognised, and the frequency of this problem among African malnourished children is unclear.Objectives: To determine the magnitude of hypo-phosphataemia in children under five years of age presenting to Kenyatta National Hospital with kwashiorkor and marasmic kwashiorkor and to evaluate the relationship between hypo- phosphataemia and nutritional intervention during the first five days of treatment.Design: Short longitudinal survey.Setting: The General Paediatric wards of the Kenyatta National Hospital (KNH), Nairobi.Subjects: Children under five years of age presenting with kwashiorkor or marasmic kwashiorkor at KNH were recruited into the study. Main outcome measures: Low serum phosphate level