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Hyponatraemia and dehydration in severe malaria

M C English1, C Waruiru, C Lightowler

  • 1Nuffield Department of Medicine, John Radcliffe Hospital, Headington, Oxford, United Kingdom.

Archives of Disease in Childhood
|March 1, 1996
PubMed
Summary

Hyponatremia is common in severe childhood malaria, affecting over half of patients. Children with hyponatremia were less dehydrated, suggesting appropriate antidiuretic hormone secretion, unlike those with normal sodium levels.

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Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Nephrology

Background:

  • Severe childhood malaria presents complex fluid and electrolyte challenges.
  • Hyponatremia is a frequently observed complication in pediatric malaria cases.

Purpose of the Study:

  • To investigate the prevalence and underlying causes of hyponatremia in severe childhood malaria.
  • To assess the relationship between hyponatremia, dehydration, and renal function in these patients.

Main Methods:

  • Prospective recruitment of 132 children with severe malaria, including 47 with cerebral malaria.
  • Serial monitoring of fluid balance, electrolytes, and renal function indices during hospitalization.

Main Results:

  • Hyponatremia (sodium < 135 mmol/l) was present in 55% of children on admission.

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  • Hyponatremic children exhibited less weight gain and were less dehydrated compared to those with normal sodium levels.
  • Dehydration was common (31% of survivors) and associated with higher urea and more acidosis on admission, with improved renal function markers at discharge.

    • Conclusions:

    • Dehydration is a significant issue in severe childhood malaria, potentially impairing renal function.
    • Hyponatremia in this context may indicate appropriate antidiuretic hormone secretion and less water depletion.