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Children with hyponatremia in the absence of sepsis are at greater risk of AKI
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SAN DIEGO — Critically ill children who are admitted to the ICU with hyponatremia without sepsis are at greater risk of developing an acute kidney injury, according to data presented at ASN Kidney Week 2018.
“What we saw is that in pediatric patients admitted to the ICU without sepsis, all causes, that there was an increased risk for AKI stage two or three defined by [The Kidney Disease: Improving Global Outcomes] KDIGO guidelines,” study co-author Cassandra Lynn Formeck, MD, of the Children’s Hospital of Pittsburgh of the University of Pittsburgh Medical Center, said during her presentation of the retrospective study.
To analyze potential relationships between hyponatremia, AKI, sepsis and nephrotoxic drug exposure, researchers used a pediatric ICU database to identify 5,300 patients. The mean age of the patients was 7.5 years and 58% were boys.
“What we were interested in is looking at hyponatremia as a risk factor for AKI if you came into the ICU with hyponatremia that was measured within 6 hours of ICU admission and [whether] AKI occurred on days 2 through 8 of the ICU stay,” Formeck said.
Formeck and colleagues found the incidence of stage two or three AKI was 8.8% in patients who presented with hyponatremia and sepsis but was 14.7% for patients with hyponatremia who were admitted without sepsis. The researchers concluded that patients without sepsis who were admitted to the ICU with hyponatremia and were medicated with nephrotoxic drugs experienced an elevated risk of AKI.
“More investigation needs to look at adjusting for other potential risk factors that may contribute to hyponatremia, such as volume overload, but more studies are needed to look at other covariates that could potentially modify hyponatremia as a risk factor,” Formeck said. “It’s possible that hyponatremia, in of itself, could be a risk factor for acute kidney injury in critically ill children.” – by Kristine Houck, MA, ELS, and Scott Buzby
Reference:
Formeck CL, et al. Abstract TH-PO013. Presented at: ASN Kidney Week; San Diego; Oct. 23-28, 2018.
Disclosure: Formeck reports no relevant financial disclosures.