title: Hyponatremia in hospitalized children.
abstract: To determine the frequency, causes, and clinical significance of hyponatremia in hospitalized children, we reviewed the clinical and laboratory data of all hyponatremic children in Texas Children's Hospital over a 12-month period. One hundred sixty-one patients from among 11,702 hospital admissions were found to have hyponatremia, defined as serum sodium value of less than 130 mEq/L, an overall frequency of 1.38%. Sixty-nine patients (43%) had hyponatremia on admission, and 92 patients (57%) had hospital-acquired hyponatremia. Thirty-seven (23%) were previously healthy children, and 124 (77%) had chronic illnesses. Acute gastroenteritis was the leading cause of hyponatremia present on admission, and diuretic therapy was the leading cause of hospital-acquired hyponatremia. Only four patients (2.5%) had a serum sodium concentration of less than 120 mEq/L. Six patients (3.7%) had neurologic impairment on discharge, and 19 patients (12%) ultimately died long after their hyponatremia was corrected. Each patient who had neurologic sequelae and each patient who died had underlying medical conditions which could explain their morbidity and/or mortality. The prognosis appears to be more clearly related to the underlying medical disorder rather than to the hyponatremic state or its correction.
authors.affiliation: Department of Pediatrics, Baylor College of Medicine, Houston, Texas.
authors.forename: A
authors.initials: A
authors.lastname: Wattad
authors.forename: M L
authors.initials: ML
authors.lastname: Chiang
authors.forename: L L
authors.initials: LL
authors.lastname: Hill
mesh_terms: D000293:Adolescent; D002648:Child; D002673:Child, Hospitalized; D002675:Child, Preschool; D002908:Chronic Disease; D004232:Diuretics / Q000009:adverse effects; D004487:Edema / Q000150:complications; D005260:Female; D005759:Gastroenteritis / Q000150:complications; D006801:Humans; D007010:Hyponatremia / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D007223:Infant; D007552:Isotonic Solutions; D008297:Male; D012189:Retrospective Studies; D012964:Sodium / Q000097:blood; D012965:Sodium Chloride / Q000627:therapeutic use; D013781:Texas / Q000453:epidemiology
chemical_list: D004232:Diuretics; D007552:Isotonic Solutions; D012965:Sodium Chloride; D012964:Sodium