Serum electrolytes in children with heart failure on diuretic therapy at Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania: a cross-sectional study

Abstract

Introduction: diuretic therapy is among the cornerstones of the management of heart failure in children with acquired or congenital heart diseases (CHD). Electrolyte derangements have been reported by various studies to be among the most common side effects following diuretic therapy. Despite that, there is limited documentation on the magnitude of this problem in our setting. This study, therefore, aimed to identify clinical characteristics and determine the magnitude of electrolyte abnormalities among children with heart failure who were on diuretic therapy at Jakaya Kikwete Cardiac Institute, Tanzania.

Methods: this was a hospital-based cross-sectional study was conducted among children with heart failure admitted at Jakaya Kikwete Cardiac Institute (JKCI), Dar es Salaam, Tanzania. A pretested structured questionnaire was used to collect data on socio-demographics, clinical characteristics, and levels of serum electrolytes.

Results: a total of 385 children whose ages ranged from 1 month to 18 years were enrolled in this study. Most of them (271 (70%)) were below 5 years and their median age was 2.1 (IQR=0.8-6) years. Ventricular septal defect (VSD) was the most common acyanotic CHD, observed in 122 children out of 385 (31.6%). Nearly half (186 (48%)) of the children were in class IV of the Ross Heart Failure Classification. Slightly more than half of the study participants (202 (53%)) and 182 (47%) of the children had hyponatremia and hypocalcemia respectively. Only 8% (32/385) had hypokalemia. There was no observed association between hyponatremia and furosemide dosage (P=0.33) in children in this study.

Conclusion: a significant number of children with heart failure on diuretic therapy had hyponatremia and hypocalcemia hence, routine electrolytes monitoring is recommended.