اهميت هيپوناترمي در عفونت‌هاي تب‌دار دستگاه ادراري كودكان: گزارش كوتاه

The importance of hyponatremia in febrile urinary tract infection in children: brief report

زمینه و هدف: عفونت دستگاه ادراری، بیماری شایع در كودكان است. این مطالعه به‌منظور بررسی ارتباط هایپوناترمی با شدت عفونت مجاری ادراری انجام گردید. روش بررسی: این مطالعه توصیفی-تحلیلی-مقطعی در بیمارستان گلستان اهواز و طی سال‌های 1391-1390 انجام گرفت. 120 كودك مبتلا به عفونت دستگاه ادراری واجد شرایط ورود به مطالعه در دو گروه مساوی هایپوناترمیك و غیرهایپوناترمیك، تقسیم شده و مورد مطالعه قرار گرفتند. داده‌های بیماران در طی دوران بستری ثبت گردید. یافته‌ها: متوسط شمارش White blood cell (WBC)، مثبت شدن C-reactive protein (CRP)، متوسط Erythrocyte sedimentation rate (ESR) و متوسط طول مدت تب‌دار بودن به‌طور معناداری در بیماران هایپوناترمیك بیشتر بود. نتیجه‌گیری: مطالعه حاضر نشان داد بین هایپوناترمی و شدت بیشتر عفونت دستگاه ادراری ارتباط معناداری وجود دارد.

Background: Urinary tract infection is a common infectious disease in children and associated with the risk for renal scarring and long-term complications, usually consists of pyelonephritis and may cause complications such as scars in kidney, hypertension and renal failure. Some studies demonstrated association between urinary tract infection and electrolyte disturbances such as hyponatremia. The present study has been designed for assessment of association between urinary tract infection and hyponatremia in children. Methods: This is a descriptive, cross-sectional study has been conducted on 120 children have referred to the Golestan Hospital, Ahvaz Jundishapur University of Medical Science from 21 March 2011 until 20 March 2013. A total of 120 children who were aged 6 months to 12 years and had febrile urinary tract infection. The study population and were classified into two group of sixty children: hyponatremic and nonhyponatremic. We compared the laboratory findings in two groups with each other. The data included serum sodiom level, white blood cell (WBC) count, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and ddimercaptosuccinic acid (DMSA) scan results collected from children with febrile urinary tract infections admitted in pediatric ward. Data analysis was performed using descriptive statistics, chi-square and independent T-test with SPSS software, ver. 20 (IBM, Armonk, NY, USA). Results: In this study, 120 patients, 104 females (86.7%) and 16 males (13.3%) aged six months to 12 years were evaluated. All the patients were studied in terms of positive DMSA Scan. In the first group (hyponatremic) 31, and the second group (without hyponatremia) 13 patients were identified. There was a significant association between hyponatremia and WBC count, ESR, CRP, duration of fever and abnormal DMSA scan. Conclusion: We conclude that there is significant association between hyponatremia and severity of urinary tract infection in children.