Sodium Disturbances in Children Admitted to a Kenyan Hospital: Magnitude, Outcome and Associated Factors.
BACKGROUND
Perturbations of blood sodium are the most frequently encountered electrolyte disorder in sick children, and may influence fluid therapy. We examined the frequency of blood sodium perturbations, and factors and outcomes associated with hyponatremia in children admitted to a rural Kenyan hospital and investigated the risk factors associated with deaths in hyponatremic children.


METHODS
Plasma sodium levels and other laboratory parameters were measured in children admitted to a rural Kenyan hospital. Clinical measurements were collected using standard forms and entered into a computer database. The proportion of children admitted with hyponatremia was determined. Logistic regression models were used to investigate factors associated with hyponatremia, and death in those with hyponatremia.


RESULTS
Abnormal plasma sodium occurred in 46.6% (95% confidence interval (95%CI) 43.5-49.6%) of 1026 pediatric admissions. Hyponatremia occurred in 44.4% (95%CI 41.4-47.5%) and hypernatremia in 2.1% (95%CI 1.3-3.0%). Malaria (40.8%) was the most common underlying primary diagnosis in hyponatremic children. Malaria, hyperglycemia, wasting, high creatinine levels and preserved consciousness were associated with hyponatremia. Pallor and seizures were associated with increased mortality in hyponatremic children.


CONCLUSIONS
Sodium disturbances are common in pediatric admissions to a County hospital in rural Kenya. Seizures and pallor were predictors of mortality in hyponatremic children.
KEMRI-Wellcome Trust Research Programme, Centre for Geographic Medicine Research - Coast, P.O Box 230-80108, Kilifi, Kenya.
Fredrick
F
Ibinda
KEMRI-Wellcome Trust Research Programme, Centre for Geographic Medicine Research - Coast, P.O Box 230-80108, Kilifi, Kenya.
Hans-Christoph
HC
Zarnack
KEMRI-Wellcome Trust Research Programme, Centre for Geographic Medicine Research - Coast, P.O Box 230-80108, Kilifi, Kenya.|Department of Psychiatry, University of Oxford, Oxford, United Kingdom.
Charles R
CR
Newton
D002648:Child; D005260:Female; D005440:Fluid Therapy; D006760:Hospitalization; D006801:Humans; D006955:Hypernatremia / Q000097:blood* / Q000503:physiopathology / Q000628:therapy; D007010:Hyponatremia / Q000097:blood* / Q000503:physiopathology / Q000628:therapy; D007630:Kenya; D008297:Male; D012307:Risk Factors; D012640:Seizures / Q000097:blood / Q000503:physiopathology / Q000628:therapy; D012964:Sodium / Q000097:blood*; D012982:Sodium, Dietary / Q000008:administration & dosage
D012982:Sodium, Dietary; D012964:Sodium