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- W4220664688 abstract "Nichols BL, Alvarado J, Hazlewood CF, Viteri F. Clinical significance of muscle potassium depletion in protein-calorie malnutrition. J Pediatr 1972;80:319-30. Malnutrition continues to be a major public health problem and a significant cause of under-5 mortality throughout the developing world. Severe malnutrition is characterized by excess body sodium and deficiency of potassium. Nichols et al in 1972 studied the mechanism and clinical significance of serum and muscle potassium depletion in children with edematous protein calorie malnutrition. They concluded that the low muscle potassium concentration was secondary to the decrease in the muscle mass, rather than to desaturation of the muscle potassium content. The authors emphasized the need for nutrition rehabilitation ahead of potassium supplementation. The evolution of the management of malnourished children over the last 5 decades underlines the importance of potassium supplementation with respect to improvement in survival and outcome.1Manary M.J. Brewster D.R. Potassium supplementation in kwashiorkor.J Pediatr Gastroenterol Nutr. 1997; 24: 194-201Google Scholar It is proven that, in severe malnutrition, the tissues are grossly depleted in potassium and there is a strongly positive balance during recovery.2Golden M.H. Proposed recommended nutrient densities for moderately malnourished children.Food Nutr Bull. 2009; 30: S267-S342Google Scholar The World Health Organization recommendations for physiology-based management of children with severe acute malnutrition, updated in 2013, states that normalization of potassium balance is possible only after restoration of the homeostatic mechanisms and rapid intravenous supplementation of potassium can increase mortality.3World Health OrganizationWHO guideline: updates on the management of severe acute malnutrition in infants and children. World Health Organization, Geneva2013Google Scholar The World Health Organization recommends a slow correction of hypokalemia over a period of 2 weeks or longer using potassium supplements in hospitalized children with complicated severe acute malnutrition, or using ready to use therapeutic food for the community-based management of uncomplicated severe acute malnutrition. Rapid intravenous correction is reserved only for severe hypokalemia, especially in severely malnourished children with complicated with diarrhea and dehydration. This is followed by oral supplementation at a dose of 3-4 mEq/kg/d over 2 weeks. Children with malnutrition are depleted in potassium and the serum electrolyte levels only reflect the circulating concentrations rather than the total body content. Hence, it is important to correct the deficiency and replete the stores to maintain the homeostatic milieu in malnourished children. As also suggested by Nichols et al, the primary emphasis continues to be on therapeutic nutritional rehabilitation." @default.
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- W4220664688 date "2022-04-01" @default.
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- W4220664688 title "50 Years Ago in T J P" @default.
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- W4220664688 doi "https://doi.org/10.1016/j.jpeds.2021.11.046" @default.
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