Publication:

Electrolyte disturbances in infants with enterostomy: a prospective analysis

Background Aim was to prospectively evaluate the incidence, pattern, and longitudinal trends of electrolyte disturbances, including serum electrolytes and urinary sodium levels, in infants with enterostomies compared to controls.

Methods This prospective case-control study was conducted at a tertiary care center between May 2023 and December 2024. Fifty infants aged 0-3 months undergoing ileostomy were compared with 50 age-and sex-matched controls without malabsorption. Serum electrolytes (sodium, potassium, calcium, phosphate, magnesium) and urinary sodium were assessed at discharge and at 1, 3, and 6 months. Electrolyte abnormalities were defined using standard pediatric reference ranges, and urinary sodium <10 mmol/L indicated sodium depletion.

Results Infants with ileostomy demonstrated a significantly higher prevalence of sodium depletion compared to controls. Urinary sodium <10 mmol/L was observed in 50%, 50%, and 54.2% at 1, 3, and 6 months, respectively. Hyponatremia occurred in 62.5%, 60.4%, and 52.1% of infants at corresponding time points. Other electrolyte disturbances were less frequent but clinically relevant, with hypocalcemia and hypokalemia observed in 10.4% of infants at 6 months.

Conclusions Hyponatremia, along with low urinary sodium levels, is commonly observed in infants with enterostomies and indicates underlying total body sodium depletion secondary to ongoing gastrointestinal losses. Although other electrolyte abnormalities are less common, periodic surveillance remains important. Early recognition and targeted management are essential to optimize growth and clinical outcomes.