Urinary vitamin A loss in children with acute shigellosis

Acute infections can increase the risk of vitamin A deficiency in young children. To determine the extent of urinary vitamin A loss and the factors associated with such loss in shigellosis, 66 hospitalized children aged 5 mo to 5 yr were studied in Bangladesh. Subjects excreted up to 0.63 μmol retinol/day, with 8% of children excreting ≥ 20% of the daily metabolic requirement of 0.70 μmol. Retinol excretion (μmol/day) was significantly higher in children with S. dysenteriae type 1 infection (0.048 ± 0.127 vs. 0.002 ± 0.005, p = 0.0003), and fever > 38.5° C (0.061 ± 0.140 vs. 0.002 ± 0.007, p < 0.0001). In a multiple regression analysis, body temperature (β =0.1029, p = 0.04), creatinine clearance (β = 0.0086, p = 0.009), and tubular reabsorption of β2-microglobulin (β = -0.2971, p < 0.0001) were significant predictors of retinol excretion, while tubular reabsorption of retinol-binding protein and phosphate, urinary albumin concentration, weight-for-age, Shigella type, and age were not. In conclusion, fever and changes in kidney function are independent predictors of urinary retinol loss in children with shigellosis.