Frequency of Hypokalemia in Children with Acute Watery Diarrhea

Acute watery diarrhea (AWD) remains a major cause of pediatric admissions, and electrolyte disturbances account for much of its morbidity. Hypokalemia is clinically important, yet its relationship with serum chloride is not consistently reported in hospital-based studies. Objective: To determine the frequency of hypokalemia among hospitalized children with AWD and examine its association with serum chloride categories and selected demographic and clinical factors. Methods: An analytical cross-sectional study was conducted on children aged 6 months to 12 years admitted with AWD. Data on demographics, clinical features, and laboratory parameters (serum potassium, sodium, chloride, bicarbonate, and acid–base status) were collected using a structured proforma. Hypokalemia was defined as serum potassium <3.5 mmol/L. Associations were assessed using the Chi-square test, with effect size reported as Cramér’s V. Results: A total of 103 children were analyzed. Hypokalemia was present in 58.3% of cases. Serum chloride was the only variable significantly associated with hypokalemia (χ² = 6.66, df = 2, p = 0.036; Cramér’s V = 0.25). Hypokalemia was most frequent in hypochloremia (77.3%) and least frequent in hyperchloremia (30.0%). No significant associations were observed with age, sex, nutritional status, dehydration, sodium, bicarbonate, or categorical acid–base status. Conclusions: Hypokalemia is common in pediatric AWD and is significantly associated with serum chloride categories. Routine electrolyte testing that includes chloride, together with timely potassium correction and fluid planning, is essential to improve outcomes.