title: Analysis of Risk Factors for Hyponatremia During or Following Chemotherapy in Children With Cancer: A Hospital-based, Retrospective Cohort Study.
abstract: Hyponatremia is the most common electrolyte abnormality in hospitalized patients. The objective of this study was to identify risk factors for hyponatremia during chemotherapy in children. A total of 111 consecutive pediatric patients (age, 0 to 18 y) with hematological malignancy (n=87) or solid tumor (n=24) who received chemotherapy in our hospital between 2010 and 2014 were enrolled. The number of chemotherapy cycles reviewed was 472, with a median of 3 (range, 1 to 8) per patient. Hyponatremia was defined as a serum sodium level of <135 mmol/L. Hyponatremia was observed in 80 of 111 (72%) patients, and 138 of 472 (29%) cycles. Neurological sequelae were seen in 2 of 111 (2%) patients, and 2 of 472 (0.4%) cycles. Multivariate logistic regression identified age 10 to 18 years (odds ratio [OR]=3.24, 95% confidence interval [CI], 2.07-5.07), total parenteral nutrition (OR=8.15, 95% CI, 2.17-30.5), first or second chemotherapy cycle (OR=1.74, 95% CI, 1.12-2.70) as independent risk factors for hyponatremia. Clinical conditions of patients and chemotherapeutic agents may have a profound impact on the development of hyponatremia. Patients with these factors should be managed carefully to prevent severe symptoms and sequelae caused by hyponatremia.
authors.affiliation: Department of Pediatrics, Sapporo Hokuyu Hospital, Shiroishi-ku, Sapporo, Hokkaido, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Kishimoto
authors.forename: Ryoji
authors.initials: R
authors.lastname: Kobayashi
authors.forename: Hirozumi
authors.initials: H
authors.lastname: Sano
authors.forename: Daisuke
authors.initials: D
authors.lastname: Suzuki
authors.forename: Kazue
authors.initials: K
authors.lastname: Yasuda
authors.forename: Kunihiko
authors.initials: K
authors.lastname: Kobayashi
mesh_terms: D000293:Adolescent; D000970:Antineoplastic Agents / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007010:Hyponatremia / Q000209:etiology*; D007223:Infant; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D009369:Neoplasms / Q000188:drug therapy*; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D000970:Antineoplastic Agents