Frequency of Hypokalemia in Children Presenting with Acute Diarrhea at Bacha Khan Medical Complex Swabi

Acute diarrhea is a leading cause of morbidity and mortality among children, especially the low- and middle-income countries of the globe. There are common complications such as electrolyte imbalances, notably, hypokalemia, which severely deteriorates clinical outcomes in case of the delay in their detection and prevention. This research was done in order to establish the prevalence of hypokalemia in children presenting with acute diarrhea at Bacha Khan Medical Complex, Swabi. The study followed a cross-sectional design and the participants were enrolled by using consecutive sampling across six months (August 2024 - February 2025) with 145 children (1-12 years) being enrolled. The data on demographics, clinical, and laboratory was gathered using a structured proforma. Hypokalemia was considered serum potassium levels less than 3.5 mmol/L. Data were analyzed with SPSS v23, applying stratification and Chi-square tests to evaluate associations.The mean age of participants was 5.4 ± 3.1 years, with males comprising 59.3%. Hypokalemia was identified in 56 children, yielding a frequency of 38.6%. The condition was significantly more common in the 1–5 years age group (48.4%, p=0.021) and among children from low socioeconomic backgrounds (47.6%, p=0.031). Muscle weakness, fatigue, and cramps were the predominant symptoms associated with hypokalemia. No significant differences were observed regarding gender or urban–rural distribution. Although hypokalemia was more frequent in children with vomiting and fever, these associations did not achieve statistical significance.The findings underscore hypokalemia as a common and clinically relevant complication of pediatric diarrhea, especially in younger and socioeconomically disadvantaged children. Routine electrolyte monitoring and tailored fluid therapy with potassium supplementation are essential to mitigate adverse outcomes and improve pediatric diarrheal disease management in resource-limited settings.