Hyponatremia in visceral leishmaniasis.
There are few reports linking hyponatremia and visceral leishmaniasis (kala-azar). This is a study of 55 consecutive kala-azar patients and 20 normal individuals as a control group. Hyponatremia and serum hypo-osmolality were detected in 100% of kala-azar patients. High first morning urine osmolality (750.0 ± 52.0 vs. 894.5 ± 30.0mOsm/kg H₂O, p < 0.05), and high 24-hour urine osmolality (426.0 ± 167.0 vs. 514.6 ± 132.0 mOsm/kg H₂O, p < 0.05) demonstrated persistent antidiuretic hormone secretion. Urinary sodium was high (82.3 ± 44.2 vs.110.3 ± 34.7 mEq/L, p < 0.05). Low seric uric acid occurred in 61.8% of patients and increased fractional urinary uric acid excretion was detected in 74.5% of them. Increased glomerular filtration rate was present in 25.4% of patients. There was no evidence of extracellular volume depletion. Normal plasma ADH levels were observed in kala-azar patients. No endocrine or renal dysfunction was detected. It is possible that most hyponatremic kala-azar patients present the syndrome of inappropriate antidiuretic hormone secretion.
Instituto de Nefrologia do Ceará, Fortaleza, Ceará, Brasil. elimaverde@hotmail.com
Frederico A Lima
FA
Verde
Francisco A A Lima
FA
Verde
Francisco José V
FJ
Veronese
Augusto S
AS
Neto
Galdino
G
Fuc
Emir M Lima
EM
Verde
D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D002908:Chronic Disease; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007010:Hyponatremia / Q000175:diagnosis / Q000469:parasitology*; D007898:Leishmaniasis, Visceral / Q000150:complications*; D008297:Male; D009994:Osmolar Concentration