Clinical settings and vasopressin function in hyponatraemic children.
Hyponatraemia is one of the most common electrolyte abnormalities in hospitalised children. In a prospective study we tested whether hyponatraemia is associated with sustained release of the antidiuretic hormone arginine vasopressin (AVP). Out of 27 children with persistent hyponatremia (serum sodium < 130 mmol/l), 25 had measurable plasma concentrations of AVP [median and quartiles 5.0 pg/ml (1.5-8.3)]. Volume contraction as consequence of sodium loss caused hyponatraemia in 16 patients. Hyponatraemia in the presence of extracellular volume expansion and reduced effective arterial blood volume occurred in 5 patients. Only 3 patients had normovolaemic hyponatraemia (so-called syndrome of inappropriate antidiuretic hormone secretion) and 3 suffered from chronic renal failure. It is concluded that plasma AVP concentration is measurable in most children with hyponatraemia. Non-osmotic stimulation of AVP release and lack of suppression of this hormone is an important pathogenetic mechanism of hyponatraemia in children.
Gerigk
M
M
Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Essen (GHS), Germany.
Bald
M
M
Feth
F
F
Rascher
W
W
D000293:Adolescent; D001127:Arginine Vasopressin / Q000097:blood* / Q000652:urine; D001834:Body Water; D002648:Child; D002675:Child, Preschool; D003404:Creatinine / Q000378:metabolism; D005260:Female; D006801:Humans; D007010:Hyponatremia / Q000097:blood* / Q000503:physiopathology / Q000652:urine; D007177:Inappropriate ADH Syndrome / Q000503:physiopathology; D007223:Infant; D007231:Infant, Newborn; D007668:Kidney / Q000503:physiopathology; D008297:Male; D009994:Osmolar Concentration; D011446:Prospective Studies
D001127:Arginine Vasopressin; D003404:Creatinine