Sir,

Although hypokalaemic nephropathy has alone been recognised^1,2 the extent of urine in patients with hypokalaemia and diarrhoea has not been well documented. Accordingly, we studied prospectively during March through September, 1982, 280 uncomplicated diarrhoeal children under 5 years of age admitted to a rural treatment centre of the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR, B). Of these, 139 (46%) children were hypokalaemic (Serum K+ < 3.5 mmol/L) and 150 (54%) nor­mokalaemic on admission.
Urine examinations were performed as soon as available for specific gravity using a tem­perature corrected refractometer (American Optical Corp. Buffalo, New York), presence of protein, red blood cells, pus cells (>2/high bower field regarded as abnormal) ³ casts and epithelial cells according to standard procedures⁴. Total urine output was measured for first 24hours after admission. “Z” test was used to compare data between groups.
Hypokalaemic children passed significantly larger volumes of urine with lower concentrations than normokalaemic subjects (Table).

Signifi­cantly higher proportion of hypokalaemic children passed protein and pus cells in the urine than normokalaemic group.
Potassium along with other electrolytes is lost in diarrhoeal stool of all ages but more in cases of children. ^5,6 We found a significant number of children with hypokalaemia (46%) following diarrhoea. Routine analysis of urine during diarrhoea may provide useful information in relation to hypokalaemia. This might be helpful for therapeutic measures in children with diar­rhoea.

Yours sincerely,
K.Zaman, A:H.Baqai, Md. Yunus
International Centre for Diarrhoeal Disease Research, Bangladesh, G.P.O Box. 128, Dhaka-2 Bangladesh.

1. Conn, J.W. and Johnson, R.D. Kaliopenic nephro­pathy. Am. J. Cim. Nutr., 1956;4:523.
2. Rubini, M.E. Water excretion in potassium-deficient man. J. Clin. Invest., 1961; 40: 2215.
3. Baker, F.J. and Silverton, R.E. Introduction to Medical Laboratory Technology. 5th ed. London, Butterworth, 1976, p.243.
4. Hunter, D. and Bomford, R.R. Hutchison’s clinical methods, 15th ed. London, Bailliere, 1968, P. 172.
5. Moth, A.M., Rahman, M., Sarker, S.A., Sack, D.A. and Molla, A. Stool electrolyte content and purging rates in diarrhoea caused by rotavirus, entero­toxigenic E. cohi, and V. cholerae in children. J.         Pediatr., 1981;98:835.
6. Greenough, W.B.III. Principles and prospects in the treatment of cholera and related dehydrating diarrhoeas. Cholera and related diarrhoeas. 43rd Nobi Symp Stockholm 1978, p. 211.