Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 May;62(5):576-580.
doi: 10.1111/ped.14115.

Characteristics of nonoliguric hyperkalemia in preterm infants: A case-control study in a single center

Kuraaki Aoki  1 , Kazuhiro Akaba  1
Affiliations

Characteristics of nonoliguric hyperkalemia in preterm infants: A case-control study in a single center

Kuraaki Aoki et al. Pediatr Int. 2020 May.

Abstract

Background: Preterm infants often present with hyperkalemia during the first days after birth without showing oliguria. This is known as nonoliguric hyperkalemia (NOHK). As its clinical features have not been completely understood to date, we aimed to elucidate the characteristics of NOHK, including its risk factors, in preterm infants.

Methods: For this case-control study, we reviewed the files of all infants born before 32 weeks of gestational age in our neonatal intensive care unit between 2011 and 2018. We distinguished the NOHK and non-NOHK groups and compared their characteristics and blood potassium levels. Nonoliguric hyperkalemia was defined as peak blood potassium concentration of ≥6.0 mmol/L during the first 72 h of life with a urine output of ≥1 mL/kg/h.

Results: Of the 99 infants enrolled, 21 (21%) demonstrated NOHK. Infants with NOHK were more likely to have been exposed to antenatal magnesium sulfate (MgSO4 ) (P = 0.019) than those in the non-NOHK group. Acute morbidities and mortality were not statistically different. Multivariate analysis indicated that administration of maternal MgSO4 for longer than 24 h at any point before delivery was a risk factor for NOHK. Its adjusted odds ratio and 95% confidence interval were 4.0 and 1.4-12.3, respectively (P = 0.012).

Conclusions: In this study, maternal MgSO4 administration for longer than 24 h proved to be a risk factor for NOHK in infants born before 32 weeks of gestational age. Infants born to mothers who have received MgSO4 should be regularly monitored for their electrolytes.

Keywords: hyperkalemia; infants; magnesium sulfate; premature infants; risk factors.

PubMed Disclaimer

References

    1. Brion LP, Schwartz GJ, Campbell D, Fleischman AR. Early hyperkalaemia in very low birthweight infants in the absence of oliguria. Arch. Dis. Child. 1989; 64: 270-2.
    1. Kwak JR, Gwon M, Lee JH, Park MS, Kim SH. Non-oliguric hyperkalemia in extremely low birth weight infants. Yonsei Med. J. 2013; 54: 696-701.
    1. Tanaka K, Mori H, Sakamoto R et al. Early-onset neonatal hyperkalemia associated with maternal hypermagnesemia: A case report. BMC Pediatr. 2018; 18: 55.
    1. Vemgal P, Ohlsson A. Interventions for non-oliguric hyperkalaemia in preterm neonates. Cochrane Database Syst. Rev. 2012; 5: CD005257.
    1. Omar SA, DeCristofaro JD, Agarwal BI, LaGamma EF. Effect of prenatal steroids on potassium balance in extremely low birth weight neonates. Pediatrics 2000; 106: 561-7.

MeSH terms