The relationship between arginine vasopressin levels and hyponatremia following a percutaneous renal biopsy in children receiving hypotonic or isotonic intravenous fluids
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Kyoko Kanda & Kandai Nozu & Hiroshi Kaito & Kazumoto Iijima & Koichi Nakanishi & Norishige Yoshikawa & Takeshi Ninchoji & Yuya Hashimura & Masafumi M
- چاپ و سال / کشور: 2011
Description
Post-operative hyponatremia is a common complication in children which results from hypotonic fluid administration in the presence of arginine vasopressin (AVP) excess. We evaluated the relationship between the change in serum sodium and AVP levels following percutaneous renal biopsy in children receiving either hypotonic or isotonic fluids. This study was prompted after we encountered a patient who developed near-fatal hyponatremic encephalopathy following a renal biopsy while receiving hypotonic fluids. The relationship between the change in serum sodium and AVP levels was evaluated prior to (T0) and at 5 h (T5) following a percutaneous renal biopsy in 60 children receiving either hypotonic (0.6% NaCl, 90 mEq/L) or isotonic fluids (0.9% NaCl, 154 mEq/L). The proportion of patients with elevated AVP levels post-procedure was similar between those receiving 0.6 or 0.9% NaCl (30 vs. 26%). Patients receiving 0.6% NaCl with elevated AVP levels experienced a fall in serum sodium of 1.9±1.5 mEq/L, whereas those receiving 0.9% NaCl had a rise in serum sodium of 0.85±0.34 mEq/L with no patients developing hyponatremia. There were no significant changes in serum sodium levels in patients with normal AVP concentrations post-procedure in either group. In conclusion, elevated AVP levels were common among our patients following a percutaneous renal biopsy. Isotonic fluids prevented a fall in serum sodium and hyponatremia, while hypotonic fluids did not.
DOI 10.1007/s00467-010-1647-2 Pediatr Nephrol (2011) 26:99–104 Received: 25 March 2010 /Revised: 26 July 2010 /Accepted: 28 July 2010 /Published online: 16 October 2010
