Incidence and Outcome of Severe Hyponatremia in Children and Young Adults A Single Institution Experience

Objective: Our two main objectives are to assess the incidence and the outcome of severe hyponatremia in young hospitalizedpatients. Method: We retrospectively reviewed the incidence and outcome of severe hyponatremiac (Na ÆÌ25 mmol/l) inpatientsless than ÆÌ8 years of age, admitted as consecutive admissions during one calender year. Psuedohyponatremia and artifactualhyponatremia were excluded. Patients¡¦ demographics, clinical features, laboratory, treatment and outcomes were recorded. Results:Of 356ÆÌ admissions of patients less than ÆÌ8 years of age, 20 developed severe hyponatremia. Nausea, vomiting, irritability, cloudedsensorium and seizures were the most common symptoms and signs. Underlying central nervous system disease, pneumonia andmalignancy were major co-morbid conditions. The initial volume status was determined as hypervolemia (n=7), hypovolemia (n=7)and euvolemia (n=6). Iatrogenic (diuretics 5 and hypotonic fluids 7) hyponatremia accounted for 60% of all cases. Mortality was 20%.Conclusion: Patients receiving intravenous hypotonic fluids should be closely monitored for the development of hyponatremia. Thecommon etiology of hyponatremia in our studied cohort of patients is iatrogenic.