Hyponatremia Signals Severity in Pediatric Urinary Tract Infections: Study
Researchers have found hyponatremia to be suggestive of a worse disease course in pediatric patients with urinary tract infection (UTI), indicating acute pyelonephritis (APN), raised levels of C-reactive protein (CRP), and renal impairment. UTI is among the most common infections encountered during childhood, with its incidence occurring in about 8% of girls and 2% of boys by the age of seven years. A recent study was conducted by Fu-Wein and colleagues published in BMC Pediatrics journal.
A retrospective review was done on pediatric patients diagnosed with UTI or APN and admitted to a medical center between October 2012 and September 2022. A total of 344 patients were classified into "hyponatremia" (serum sodium levels below normal) or "eunatremia" groups based on their serum sodium concentrations. Data collected included renal ultrasound findings, blood and urine test results, and clinical outcomes. Multivariable logistic regression models were applied to assess potential predictors of disease severity, including serum glucose and CRP levels.
Key Findings
The study involved data from 344 pediatric patients:
• Hyponatremia Prevalence: Hyponatremia was found in 99 patients (28.8%), while normal serum sodium levels were found in 245 (71.2%) patients.
• Association with APN: The hyponatremia group had a higher frequency of APN and renal abnormalities detected on ultrasound.
• CRP Levels: Higher levels of CRP were observed in the hyponatremia group. A significant association was also noted in multivariable analysis (OR: 1.00; 95% CI: 1.00–1.01, p = 0.0417).
• Serum Glucose: Hyperglycemia also has been associated with hyponatremia (OR: 1.01; 95% CI: 1.00–1.03, p = 0.0365).
• Final Diagnosis APN: Hyponatremia was associated with markers of severe disease. No significant direct correlation was seen between the final diagnosis of APN.
Hyponatremia might provide useful biomarkers for significant diseases of hospitalized pediatric UTI. However, the present research shows that although hyponatremia has relationships with systemic inflammation and renal findings, its predictive ability is limited for APN diagnosis. These findings stress the need for further study on the mechanisms and clinical utility of hyponatremia as a predictor of disease severity.
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