Serum phosphate and magnesium in children recovering from severe acute undernutrition in Ethiopia: an observational study

BMC Pediatrics

Research Article

Alemseged Abdissa¹  Maren J. H. Rytter²  Christian Ritz²  Christian Mølgaard²  Kim F. Michaelsen²  Anne-Louise Hother²  Henrik Friis²  Pernille Kæstel²  André Briend³  Tsinuel Girma⁴ 

[1] Department of Laboratory Sciences and Pathology, Jimma University Specialized Hospital, Jimma, Ethiopia;Department of Nutrition, Exercise and Sports, University of Copenhagen, Rolighedsvej 30, DK-1958, Frederiksberg C, Denmark;Department of Nutrition, Exercise and Sports, University of Copenhagen, Rolighedsvej 30, DK-1958, Frederiksberg C, Denmark;Department for International Health, University of Tampere, Tampere, Finland;Department of Pediatric and Child Health, Jimma University Specialized Hospital, Jimma, Ethiopia;

关键词: Refeeding syndrome;    Hypophosphatemia;    Hypomagnesemia;    Therapeutic feeding;    Nutritional rehabilitation;    Severe acute malnutrition;   

DOI  :  10.1186/s12887-016-0712-9

 received in 2015-07-30, accepted in 2016-10-19,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundChildren with severe acute malnutrition (SAM) have increased requirements for phosphorus and magnesium during recovery. If requirements are not met, the children may develop refeeding hypophosphatemia and hypomagnesemia. However, little is known about the effect of current therapeutic diets (F-75 and F-100) on serum phosphate (S-phosphate) and magnesium (S-magnesium) in children with SAM.MethodsProspective observational study, with measurements of S-phosphate and S-magnesium at admission, prior to rehabilitation phase and at discharge in children aged 6–59 months admitted with SAM to Jimma Hospital, Ethiopia. Due to shortage of F-75, 25 (35 %) children were stabilized with diluted F-100 (75 kcal/100 ml).ResultsOf 72 children enrolled, the mean age was 32 ± 14 months, and edema was present in 50 (69 %). At admission, mean S-phosphate was 0.92 ± 0.34 mmol/L, which was low compared to normal values, but increased to 1.38 ± 0.28 mmol/L at discharge, after on average 16 days. Mean S-magnesium, at admission, was 0.95 ± 0.23 mmol/L, and increased to 1.13 ± 0.17 mmol/L at discharge. At discharge, 18 (51 %) children had S-phosphate below the normal range, and 3 (9 %) had S-phosphate above. Most children (83 %) had S-magnesium above normal range for children. Both S-phosphate and S-magnesium at admission were positively associated with serum albumin (S-albumin), but not with anthropometric characteristics or co-diagnoses. Using diluted F-100 for stabilization was not associated with lower S-phosphate or S-magnesium.ConclusionHypophosphatemia was common among children with SAM at admission, and still subnormal in about half of the children at discharge. This could be problematic for further recovery as phosphorus is needed for catch-up growth and local diets are likely to be low in bioavailable phosphorus. The high S-magnesium levels at discharge does not support that magnesium should be a limiting nutrient for growth in the F-100 diet. Although diluted F-100 (75 kcal/100 mL) is not designed for stabilizing children with SAM, it did not seem to cause lower S-phosphate than in children fed F-75.

【 授权许可】

CC BY   
© The Author(s). 2016