Tropical Doctor > Volume 38, Number 3 > Pp. 155-157

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Short Reports

Hyponatraemia and hypokalaemia in adults with uncomplicated malaria in Thailand

Vipa Thanachartwet MD   ^*    Srivicha Krudsood MD      Noppadon Tangpukdee PhD   ^*   Weerapong Phumratanaprapin MD   ^*   Udomsak Silachamroon MD   ^*   Wattana Leowattana MD   ^*   Polrat Wilairatana MD   ^*   Gary M Brittenham MD      Sornchai Looareesuwan MD FRCP   ^*   Guy H Neild MD FRCP   

^* Department of Clinical Tropical Medicine; Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, 420/6 Rajvithee Road, Ratchathevee, Bangkok 10400, Thailand; Department of Pediatrics and Medicine, Columbia University College of Physicians and Surgeons, New York, NY 10032, USA; Institute of Urology and Nephrology, University College London, London, NW1 2BU, UK

Correspondence to: Dr Vipa Thanachartwet, Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, 420/6 Rajvithee Road, Ratchathevee, Bangkok 10400, Thailand Email: tmvtn{at}mahidol.ac.th

In a retrospective study of 1415 patients aged 15 and over, we determined the incidence of clinically important hyponatraemia and hypokalaemia in adults with uncomplicated malaria. On admission, serum concentrations of sodium (135–145 mmol/L) and potassium (3.5–5.0 mmol/L) were found outside these reference ranges in 81% of patients. Severe hypokalaemia (K+ <3.0 mmol/L) and severe hyponatraemia (Na+ <125 mmol/L occurred in 4.4% and 0.6% of the patients, respectively. For hypokalaemia (43%) and hyponatraemia (37%), hypovolaemia, blood urea to creatinine ratio and high serum glucose (>100 mg/dL) were all independent factors (P < 0.001). Other independent predictors for hypokalaemia were Plasmodium vivax infection, female gender; and for hyponatraemia, P. falciparum infection, male gender, concentrations of G-6-PD and serum bicarbonate.

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