Table 4.7Incidence of biochemical disturbances in children with gastroenteritis

Study referenceNumber and age of childrenProportion of children with dehydrationProportion of children with hypernatraemiaProportion of children with hyponatraemiaProportion of children with hypokalaemiaProportion of children with urea concentration > normalProportion of children with serum bicarbonate concentration < normalProportion of children with elevated glucose
Conway et al.53n = 1148
Age range 0–10 years (37% were <6 months and 82% were <2 years)
In total, 101/1148 (9%) were dehydrated, of which:
  • 89/1148 (8%) were <5% dehydrated
  • 11/1148 (1%) were 5–10% dehydrated
  • 1/1148 was >10% dehydrated
8/1119 (0.71%)
(hypernatraemia defined as plasma sodium concentration of ≥ 150 mmol/l)
11/101 (11%) dehydrated children and 6/1047 (0.57%) children without dehydration had plasma sodium concentration of >145 mmol/l
N/AN/A10/101 (30%) of dehydrated children and 56/1047 (5%) children without dehydration had a raised urea concentration (raised urea concentration defined as >7 mmol/l)73/101 (72%) dehydrated children and 576/1047 (55%) children without dehydration had a low bicarbonate concentration (low bicarbonate concentration defined as <21 mmol/l)N/A
Ellis et al.57n = 447 admissions (21 re-admissions) made by 426 children younger than 2 years (75% were <1 year)14% had moderate or severe dehydration5 patients – no total number of patients stated 0.8%
(hypernatraemia defined as serum sodium concentration of ≥ 150 mmol/l)
N/AN/AProportion of children not stated
8% of children had raised serum urea concentration (>6 mmol/l)
Proportion of children not stated
4% of children had a low bicarbonate concentration (≤16 mmol/l)
Jenkins and Ansari58n = 215
Age range 2 weeks to 9 years (61% were < 1 year)
15/215 (7%) with severe dehydration (>5%)2/76 (2.6%)
(hypernatraemia defined as plasma sodium concentration of >145 mmol/l)
(only 35% tested)
17/76 (22%)
(serum sodium concentration within the range 128–134 mmol/l)
No definition of hyponatraemia given
N/A17/76 (22%)
(serum urea concentration >6 mmol/l)
13/76 (17.1%)
(serum bicarbonate concentration <15 mmol/l)
(lowest value 9 mmol/l)
Yurdakok and Oran79n = 19
Age range 2 months to 15 years
109/119 (91.6%) had moderate dehydration
10/119 (8.4%) had severe dehydration
9/119 (7.6%)
(hypernatraemia defined as >150 mmol/l)
1/119 (0.84%) had raised sodium of 170 mmol/l
4/119 (3.4%)
(hyponatraemia defined as <130 mmol/l)
5/119 (4.2%)
(hypokalaemia defined as <3 mmol/l)
N/A58/119 (48.7%) had a low serum bicarbonate concentration (<15 mmol/l)
15/119 (12.6%) had a serum bicarbonate concentration <10 mmol/l
13/119 (10.9%)
(hyperglycaemia defined as >140 mg/dl)
Reid and Losek80n = 528
Data presented for 196/207 children with acute gastroenteritis given IV rehydration and who had serum glucose concentration data available
Age range
1–57 months (mean age 23 months, SD 14 months)
No statement on the number of children with dehydration
207/528 (39%) received IV rehydration
N/AN/AN/A3/16 (19%) hypoglycaemic children had raised BUN
44/150 (29%) non-hypoglycaemic children had raised BUN
(raised BUN level taken as >18 mg/dl)
17/18 (94%) hypoglycaemic children had low serum bicarbonate
162/176 (92%) non-hypoglycaemic children had low serum bicarbonate
(low bicarbonate level defined as <18 mEq/l)

From: 4, Assessing dehydration and shock

Cover of Diarrhoea and Vomiting Caused by Gastroenteritis
Diarrhoea and Vomiting Caused by Gastroenteritis: Diagnosis, Assessment and Management in Children Younger than 5 Years.
NICE Clinical Guidelines, No. 84.
National Collaborating Centre for Women's and Children's Health (UK).
London: RCOG Press; 2009 Apr.
Copyright © 2009, National Collaborating Centre for Women’s and Children’s Health.

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