Hyponatremia in children: from pathophysiology to therapy
Authors:
MUDr. Ph.D. Jakub Zieg
Authors‘ workplace:
Pediatrická klinika 2. LF UK a FN Motol
Published in:
Čas. Lék. čes. 2016; 155: 145-150
Category:
Review Article
Overview
This present review analyzes the etiology, diagnostics and management of conditions associated with hyponatremia. Excess water and/or sodium wasting lead to the development of hyponatremia in children. There are diverse etiologies associated with hyponatremia, correct diagnosis is based on detailed history, physical examination and basic laboratory tests. Symptomatic hyponatremia can be a life threatening emergency and thus requires fast and vigorous management. Inappropriate treatment may cause fatal consequences.
Keywords:
hyponatremia, children, hyponatremic encephalopathy, inappropriate ADH syndrome, renal salt wasting syndrome
Sources
1. Danziger J, Zeidel M, Parker MJ. Renal Physiology: A Clinical Approach. Wolters Kluwer/Lippincott Williams & Wilkins, Philadelphia, 2012: 139–155.
2. Moritz ML, Ayus JC. Disorders of water metabolism in children: hyponatremia and hypernatremia. Pediatr Rev 2002; 23: 371–380.
3. Spasovski G, Vanholder R, Allolio B et al. Clinical practice guideline on diagnosis and treatment of hyponatraemia. Eur J Endocrinol 2014; 170: G1–G47.
4. Aw TC, Kiechle FL. Pseudohyponatremia. Am J Emerg Med 1985; 3: 236–239.
5. Zieg J. Evaluation and management of hyponatraemia in children. Acta Paediatr 2014; 103(10): 1027–1034.
6. Schrier RW, Arroyo V, Bernardi M et al. Peripheral arterial vasodilation hypothesis: a proposal for the initiation of renal sodium and water retention in cirrhosis. Hepatology 1988; 8: 1151–1157.
7. McClellan MD, Dauber IM, Weil JV. Elevated intracranial pressure increases pulmonary vascular permeability to protein. J Appl Physiol 1989; 67: 1185–1191.
8. Štarha J, Dostálková D, Štěpánková D, Doležel Z. Intoxikace vodou u malých dětí způsobená nadměrným příjmem hypotonických tekutin. Česko-slovenská pediatrie 2003; 58(2): 73–75.
9. Skalická V, Bláhová K, Janda J. Psychogenní polydipsie u batolete na podkladě návykového pití přeslazeného čaje. Praktický lékař 1999; 79(5): 268–269.
10. Zieg J, Glombová M. Psychiatric disorders are associated with increased risk for developing hyponatraemia in children. J Pediatr Endocrinol Metab 2015; 28: 1195–1196.
11. Lebl J, Kolská M, Zavacká A et al. Cerebral oedema in enuretic children during low-dose desmopressin treatment: a preventable complication. Eur J Pediatr 2001; 160: 159–162.
12. Parrott AC. MDMA and temperature: a review of the thermal effects of 'Ecstasy' in humans. Drug Alcohol Depend 2012; 121: 1–9.
13. Ayus JC, Varon J, Arieff AI. Hyponatremia, cerebral edema, and noncardiogenic pulmonary edema in marathon runners. Ann Intern Med 2000; 132: 711–714.
14. Bartter FC, Schwartz WB. The syndrome of inappropriate secretion of antidiuretic hormone. Am J Med 1967; 42: 790–806.
15. von Bismarck P, Ankermann T, Eggert P et al. Diagnosis and management of cerebral salt wasting (CSW) in children: the role of atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP). Childs Nerv Syst 2006; 22(10): 1275–1281.
16. Fenske W, Stork S, Koschker AC et al. Value of fractional uric acid excretion in differential diagnosis of hyponatremic patients on diuretics. J Clin Endocrinol Metab 2008; 93: 2991–2997.
17. Maesaka JK, Batuman V, Yudd M et al. Hyponatremia and hypouricemia: differentiation from SIADH. Clin Nephrol 1990; 33: 174–178.
18. Moritz ML, Ayus JC. New aspects in the pathogenesis, prevention, and treatment of hyponatremic encephalopathy in children. Pediatr Nephrol 2010; 25: 1225–1238.
19. Wright DG, Laureno R, Victor M. Pontine and extrapontine myelinolysis. Brain 1979; 102: 361–385.
20. Decaux G, Unger J, Brimioulle S, Mockel J. Hyponatremia in the syndrome of inappropriate secretion of antidiuretic hormone. Rapid correction with urea, sodium chloride, and water restriction therapy. JAMA 1982; 247: 471–474.
21. Robertson GL. Vaptans for the treatment of hyponatremia. Nat Rev Endocrinol 2011; 7: 151–161.
22. Bettinelli A, Longoni L, Tammaro F et al. Renal salt-wasting syndrome in children with intracranial disorders. Pediatr Nephrol 2012; 27: 733–739.
Labels
Addictology Allergology and clinical immunology Angiology Audiology Clinical biochemistry Dermatology & STDs Paediatric gastroenterology Paediatric surgery Paediatric cardiology Paediatric neurology Paediatric ENT Paediatric psychiatry Paediatric rheumatology Diabetology Pharmacy Vascular surgery Pain managementArticle was published in
Journal of Czech Physicians
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