{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T05:04:06Z","timestamp":1779685446213,"version":"3.53.1"},"reference-count":11,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T00:00:00Z","timestamp":1779667200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005357","name":"Slovak Research and Development Agency","doi-asserted-by":"publisher","award":["APVV-22-0257"],"award-info":[{"award-number":["APVV-22-0257"]}],"id":[{"id":"10.13039\/501100005357","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Scientific Grant Agency of the Ministry of Education, Science, Research and Sport of the Slovak Republic","award":["VEGA 1\/0659\/22"],"award-info":[{"award-number":["VEGA 1\/0659\/22"]}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nutr."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A total of 328 children (50.9% girls, aged 3\u202fmonths to 15\u202fyears) 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\u202f&amp;lt;\u202f7.36 and a serum bicarbonate (HCO\u2083\n                      <jats:sup>\u2212<\/jats:sup>\n                      )\u202f&amp;lt;\u202f22\u202fmmol\/L.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Metabolic acidosis occurred in 117 children (35.6%, mean age 4.93\u202f\u00b1\u202f2.14\u202fyears). In multivariate logistic regression analysis, MA was independently associated with a higher degree of dehydration (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001), absence of diarrhea (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.001), and zero oral intake (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.034), and negatively associated with BMI (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.024). Neither age nor body weight was significantly associated with MA.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fnut.2026.1737321","type":"journal-article","created":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T04:46:46Z","timestamp":1779684406000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Low BMI increases the risk of metabolic acidosis in children with dehydration"],"prefix":"10.3389","volume":"13","author":[{"given":"Juraj","family":"Stanik","sequence":"first","affiliation":[{"name":"Department of Paediatrics, Medical Faculty of the Comenius University and National Institute for Children\u2019s Diseases","place":["Bratislava, Slovakia"]},{"name":"Department of Metabolic Disorders, Institute of Experimental Endocrinology, Biomedical Research Center, Slovak Academy of Sciences","place":["Bratislava, Slovakia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simona","family":"Tarnokova","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, National Institute for Children\u2019s Diseases","place":["Bratislava, Slovakia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lenka","family":"Langerova","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Medical Faculty of the Comenius University and National Institute for Children\u2019s Diseases","place":["Bratislava, Slovakia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomas","family":"Dallos","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Medical Faculty of the Comenius University and National Institute for Children\u2019s Diseases","place":["Bratislava, Slovakia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,25]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"e72232","DOI":"10.7759\/cureus.72232","article-title":"Hypoglycemia among young children presenting with metabolic acidosis","volume":"16","author":"Ahmad","year":"2024","journal-title":"Cureus"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1016\/S0736-4679(03)00100-8","article-title":"Presenting features of idiopathic ketotic hypoglycemia","volume":"25","author":"Daly","year":"2003","journal-title":"J Emerg Med"},{"key":"ref3","first-page":"463","article-title":"Glucose counterregulatory responses to hypoglycemia","volume":"9","author":"Sprague","year":"2011","journal-title":"Pediatr Endocrinol 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One"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"e1211","DOI":"10.1542\/peds.2011-2985","article-title":"Evaluation of a clinical dehydration scale in children requiring intravenous rehydration","volume":"129","author":"Kinlin","year":"2012","journal-title":"Pediatrics"},{"key":"ref8","first-page":"126","article-title":"The 6th nationwide anthropological survey of children and adolescents in the Czech Republic in 2001","volume":"12","author":"Kobzova","year":"2004","journal-title":"Cent Eur J Public Health"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"473","DOI":"10.1186\/s12916-023-03189-8","article-title":"Clinical efficacy of sodium bicarbonate in treating pediatric metabolic acidosis with varying level of acid-base balance parameters: a real-world study","volume":"21","author":"Liu","year":"2023","journal-title":"BMC Med"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"458","DOI":"10.1186\/s12887-025-05815-1","article-title":"Sodium bicarbonate in treating lactic and non-lactic metabolic acidosis at different chloride levels: a retrospective study","volume":"25","author":"Wu","year":"2025","journal-title":"BMC Pediatr"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"e0341574","DOI":"10.1371\/journal.pone.0341574","article-title":"Body mass index is associated with hypoglycaemia in children with acute vomiting and dehydration","volume":"21","author":"Tarnokova","year":"2026","journal-title":"PLoS One"}],"container-title":["Frontiers in 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