Risk Factors of Hyponatremia in Children with Lower Respiratory Tract Infection (LRTI)

Abstract

Aim:Lower respiratory tract infection (LRTI) is a serious illness especially in children under 5 years of age. Hyponatremia is the most common electrolyte abnormality seen in hospitalized children. This study aimed to evaluate the correlation between hyponatremia in children admitted to a paediatric ward, in the setting of acute LRTI in different age groups and to determine the association of hyponatremia with different types of acute LRTI in children.Materials and Methods:This study included 231 clinically diagnosed children (1 month to 12 years) with acute LRTI. General examinations and systemic examinations were performed. Laboratory investigations included serum electrolyte level (Na+) and radiological investigations included chest X-ray. The conditions observed in the children included bronchopneumonia (BPN), lobar pneumonia, wheeze-associated LRTI (WALRI), bronchiolitis, and empyema. Statistical analysis was carried out using SPSS 16.0 version. A p-value <0.05 was considered statistically significant.Results:Out of 231 cases, hyponatremia was present in 136 cases (58.9%). Mild, moderate, and severe hyponatremia were present in 83.8%, 13.2%, and 2.9% patients, respectively. Most of the patients with BPN had mild hyponatremia (89%). The prevalence of hyponatremia was significantly higher in children aged 6-10 years [odds ratio (OD)=4.29, 95% confidence interval (CI)=0.90-20.45, p<0.05], females (OR=0.56, 95% CI=0.32-0.96, p=0.03) and cases of empyema (OR=4.49, 95% CI=1.48-13.60, p=0.008).Conclusion:In conclusion, among children hospitalized with LRTI, an older age (6-10 years), being female, and the presence of empyema are significant risk factors for the development of hyponatremia. In such children, serum electrolytes should be regularly measured to prevent adverse clinical outcomes.

Keywords

• bronchopneumonia
• electrolyte
• hyponatremia
• lower respiratory tract infection