Low BMI increases the risk of metabolic acidosis in children with dehydration.

BACKGROUND

Metabolic acidosis (MA) is one of the key factors determining the need for inpatient care in children with dehydration. This study aimed to identify risk factors for the development of MA in otherwise healthy children presenting with dehydration.

METHODS

A total of 328 children (50.9% girls, aged 3 months to 15 years) without a history of relevant chronic disease and hospitalized with acute dehydration were analyzed retrospectively. Selected anamnestic, clinical, and anthropometric factors potentially associated with MA were evaluated. MA was defined as a blood pH < 7.36 and a serum bicarbonate (HCO₃-) < 22 mmol/L.

RESULTS

Metabolic acidosis occurred in 117 children (35.6%, mean age 4.93 ± 2.14 years). In multivariate logistic regression analysis, MA was independently associated with a higher degree of dehydration (p < 0.001), absence of diarrhea (p = 0.001), and zero oral intake (p = 0.034), and negatively associated with BMI (p = 0.024). Neither age nor body weight was significantly associated with MA.

CONCLUSION

Low BMI and absence of diarrhea were identified as additional risk factors, alongside dehydration severity, for the development of MA in children with acute dehydration.