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Clinical settings and vasopressin function in hyponatraemic children
1Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Essen (GHS), Germany.
European Journal of Pediatrics
|April 1, 1993
Summary
Persistent hyponatraemia in children is often linked to sustained release of arginine vasopressin (AVP). This study found measurable AVP levels in most children with hyponatraemia, indicating its role in the condition.
Area of Science:
- Pediatric Endocrinology
- Nephrology
- Internal Medicine
Background:
- Hyponatraemia is a frequent electrolyte disorder in hospitalized children.
- The role of arginine vasopressin (AVP) in pediatric hyponatraemia requires further elucidation.
Purpose of the Study:
- To investigate the association between hyponatraemia and sustained arginine vasopressin (AVP) release in children.
- To identify the pathogenetic mechanisms of hyponatraemia in pediatric patients.
Main Methods:
- Prospective study involving 27 children with persistent hyponatraemia (serum sodium < 130 mmol/l).
- Measurement of plasma arginine vasopressin (AVP) concentrations.
- Assessment of volume status (volume contraction, extracellular volume expansion, normovolaemic).
Main Results:
- 25 out of 27 children with hyponatraemia had measurable plasma AVP concentrations (median 5.0 pg/ml).
- Volume contraction was the cause in 16 patients, while 5 had extracellular volume expansion.
- Syndrome of inappropriate antidiuretic hormone secretion (SIADH) and chronic renal failure were identified in 3 patients each.
Conclusions:
- Plasma AVP is measurable in the majority of children experiencing hyponatraemia.
- Non-osmotic AVP stimulation and impaired AVP suppression are key pathogenetic mechanisms in pediatric hyponatraemia.