Incidence and Severity of Community- and Hospital-Acquired Hyponatremia in Pediatrics

Abstract

Hyponatremia is the most common electrolyte disturbance in hospitalized children, with a reported incidence of 15–30%, but its overall incidence and severity are not well known. The objective of our study was to determine the incidence, severity, and associated risk factors of community- and hospital-acquired hyponatremia on a general pediatric ward. Data of 5550 children admitted from June 2012 to December 2019 on plasma sodium and discharge diagnosis were analyzed by logistic regression model. Clinically relevant diagnostic groups were created. Hyponatremia was classified as mild, moderate, and severe. The incidence of community- and hospital-acquired hyponatremia was 15.8% and 1.4%, respectively. Most of the cases were mild (90.8%) to moderate (8.6%), with only two cases of severe community-acquired hyponatremia. There were no clinical complications in any of the hyponatremic children. Age and diagnosis at discharge were principal factors significantly correlated with hyponatremia. Community-acquired hyponatremia is more common than hospital-acquired hyponatremia in clinical practice. Severe cases of both types are rare. Children from 2 to 11 years of age presenting with infections, cardiovascular disorders, and gastrointestinal disorders are at risk of developing hyponatremia.

Case report: Acute severe hyponatremia-induced seizures in a newborn: a community-acquired case and literature review

“…A recent study reported a 4.3% prevalence of neonatal hyponatremia, predominantly in preterm neonates within hospital settings ( Storey et al, 2019 ). However, in a study analyzing 5,550 pediatric admissions, the incidence of community-acquired hyponatremia was found to be more common (15.8%) than hospital-acquired (1.4%), with the majority of cases being mild to moderate in severity and severe instances being notably rare ( Rius-Peris et al, 2022 ). The etiological spectrum of neonatal hyponatremia is diverse, including iatrogenic factors, abnormalities in the renal mineralocorticoid pathway, inappropriate antidiuretic hormone secretion (SIADH), acute renal failure, heart failure, and gastrointestinal conditions such as gastroenteritis ( Mazzoni et al, 2019 ), congenital chloride diarrhea ( Wedenoja et al, 2010 ; Cendal et al, 2021 ), and necrotizing enterocolitis (NEC) ( Palleri et al, 2022 ).…”