Hypernatraemia surveillance during a national diarrhoeal diseases control project in Egypt

Fayad, Ibrahim; Kamel, M. M.; Hirschhorn, Norbert; Abu-Zikry, M.

doi:10.1016/0140-6736(92)90079-i

Cited by 19 publications

(14 citation statements)

References 11 publications

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“…In accordance with this notion, a recent study demonstrated that fructose-induced hypertension is initiated by increased absorption of NaCl and fructose in the intestine [38]. It is also noteworthy that ORS was occasionally associated with hypernatremia [39], implying that there is a decrease of Na + recycling system activity in cases of infectious diarrhea ( Figure 9B). In summary, our data indicate that claudin-15 is important for luminal Na + homeostasis and Na + -dependent nutrient absorption.…”

Section: Physiological Relevance Of the Na + Recirculation System In supporting

confidence: 69%

Na+-Coupled Nutrient Cotransport Induced Luminal Negative Potential and Claudin-15 Play an Important Role in Paracellular Na+ Recycling in Mouse Small Intestine

Nakayama

Ishizuka

Hempstock

et al. 2020

IJMS

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Many nutrients are absorbed via Na+ cotransport systems, and therefore it is predicted that nutrient absorption mechanisms require a large amount of luminal Na+. It is thought that Na+ diffuses back into the lumen via paracellular pathways to support Na+ cotransport absorption. However, direct experimental evidence in support of this mechanism has not been shown. To elucidate this, we took advantage of claudin-15 deficient (cldn15−/−) mice, which have been shown to have decreased paracellular Na+ permeability. We measured glucose-induced currents (ΔIsc) under open- and short-circuit conditions and simultaneously measured changes in unidirectional 22Na+ fluxes (ΔJNa) in Ussing chambers. Under short-circuit conditions, application of glucose resulted in an increase in ΔIsc and unidirectional mucosal to serosal 22Na+ (∆JNaMS) flux in both wild-type and cldn15−/− mice. However, under open-circuit conditions, ΔIsc was observed but ∆JNaMS was strongly inhibited in wild-type but not in cldn15−/− mice. In addition, in the duodenum of mice treated with cholera toxin, paracellular Na+ conductance was decreased and glucose-induced ∆JNaMS increment was observed under open-circuit conditions. We concluded that the Na+ which is absorbed by Na+-dependent glucose cotransport is recycled back into the lumen via paracellular Na+ conductance through claudin-15, which is driven by Na+ cotransport induced luminal negativity.

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Section: Physiological Relevance Of the Na + Recirculation System In supporting

confidence: 69%

Na+-Coupled Nutrient Cotransport Induced Luminal Negative Potential and Claudin-15 Play an Important Role in Paracellular Na+ Recycling in Mouse Small Intestine

Nakayama

Ishizuka

Hempstock

et al. 2020

IJMS

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“…191 The higher sodium concentration and osmolarity of standard ORS in this setting have been associated with occasional hypernatremia. 192 Efforts to improve on the original ORS formulation focused initially on the use of alternative substrates for sodium co-transport, such as the amino acids glycine, alanine, and glutamine. Among some patients with malnutrition, glutamine-based ORS may offer added nutritional benefit, but further investigations are needed.…”

Section: Controversies In Managementmentioning

confidence: 99%

Infectious Diarrhea in Developed and Developing Countries

Cheng¹,

McDonald²,

Thielman³

2005

Journal of Clinical Gastroenterology

108

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Diarrhea from gastrointestinal infection remains a common problem. In industrialized countries, management is aimed at reducing morbidity and defining groups that may benefit from further investigation. Most infectious diarrhea is self-limiting and only requires supportive management. Viral agents are increasingly recognized as causative agents of epidemic and sporadic diarrhea. In developing countries, diarrhea is a major cause of mortality in children. Oral rehydration therapy, guided by a clinical assessment of the degree of dehydration, is cheap, simple, and effective and remains the mainstay of management of infant diarrhea. Controversies focus on the optimal formulation of oral rehydration solution. A vaccine against rotavirus has the potential to save millions of lives worldwide.

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“…The use of ORS as a treatment for mild to moderate dehydration both at home and within the hospital dates back to the 1970s [13]. The nationwide introduction of ORS to Nigeria has led to the improvement in diarrhoea case management and a fall in infant and child mortality [13]. With the wider use of ORS prepared from packets, the incidence of hypernatraemia has increased despite intense media campaigns and community health education programmes [9].…”

Section: Discussionmentioning

confidence: 99%

Symptomatic Hypernatraemia Secondary to Ingestion of Poorly Constituted Oral Rehydration Solution – A Case Report

Okechukwu

Briggs

2020

AJPR

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Aim: Hypernatremia is a recognized complication of poorly constituted Oral Rehydration Solution (ORS) use that can cause neurological manifestations which require careful but often challenging management to prevent morbidity and mortality. Herein we report a case of symptomatic hypernatremia in a 2-year-old boy following ingestion of poorly constituted Oral Rehydration Solution (ORS) and highlight challenges in management. Presentation of Case: This is a case report of a 2-year-old male who presented with a four-day history of vomiting and fever. He received four litres of hyper-concentrated ORS (1 packet of ORS to 0.7 l of water) prior to presentation. At presentation, he was lethargic and subsequently lapsed into unconsciousness. He also developed focal and generalized seizures. Serial serum electrolytes testing showed hypernatremia which ranged from 157-161 mmol/L in the first 48 hours of admission for which appropriate intravenous fluids were given. Serum sodium levels gradually returned to normal (140-142 mmol/L) with treatment. He subsequently regained full consciousness after four days in a coma and was discharged home in satisfactory clinical condition. Conclusion: This case is being reported to highlight the important role of proper history taking, careful fluid and electrolyte monitoring in the diagnosis and care of this condition and emphasise on adequate education of caregivers by clinicians and the mass media on appropriate preparation of ORS.

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Hypernatraemia surveillance during a national diarrhoeal diseases control project in Egypt

Cited by 19 publications

References 11 publications

Na+-Coupled Nutrient Cotransport Induced Luminal Negative Potential and Claudin-15 Play an Important Role in Paracellular Na+ Recycling in Mouse Small Intestine

Na+-Coupled Nutrient Cotransport Induced Luminal Negative Potential and Claudin-15 Play an Important Role in Paracellular Na+ Recycling in Mouse Small Intestine

Infectious Diarrhea in Developed and Developing Countries

Symptomatic Hypernatraemia Secondary to Ingestion of Poorly Constituted Oral Rehydration Solution – A Case Report

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