Inflammation and hyponatremia: an underrecognized condition?

• Published in: Clinical and experimental pediatrics Vol. 56; no. 12; pp. 519 - 522
• Main Authors: Park, Se Jin, Shin, Jae Il
• Format: Journal Article
• Language: English
• Published: Korea (South) Clinical and Experimental Pediatics / Korean Pediatric Society 01.12.2013; The Korean Pediatric Society; Korean Pediatric Society; 대한소아청소년과학회
• Subjects: Adenosine triphosphatase; Blood; Conflicts of interest; Critical condition; Cytokines; Hospitalization; Hyponatremia; Hypotheses; Inappropriate ADH Syndrome; Inflammation; Inflammatory disease; Inflammatory diseases; Kawasaki disease; Meningitis; Patients; Physiology; Review; Sodium; Urinary tract infections; 소아과학; Critical condition; Hyponatremia; Cytokines; Inappropriate ADH Syndrome; Inflammatory disease
• ISSN: 1738-1061; 2092-7258; 2713-4148
• DOI: 10.3345/kjp.2013.56.12.519

Timely diagnosis of hyponatremia is important for preventing potential morbidity and mortality as it is often an indicator of underlying disease. The most common cause of eurvolemic hyponatremia is the syndrome of inappropriate antidiuretic hormone (SIADH) secretion. Recent studies have demonstrated that proinflammatory cytokines such as interleukin (IL) 1β and IL-6 are involved in the development of hyponatremia, a condition that is associated with severe inflammation and is related to antidiuretic hormone (ADH) secretion. Serum sodium levels in hyponatremia are inversely correlated with the percentage of neutrophils, C-reactive protein, and N-terminal-pro brain type natriuretic peptide. Additionally, elevated levels of serum IL-6 and IL-1β are found in inflammatory diseases, and their levels are higher in patients with hyponatremia. Because it is significantly correlated with the degree of inflammation in children, hyponatremia could be used as a diagnostic marker of pediatric inflammatory diseases. Based on available evidence, we hypothesize that hyponatremia may be associated with inflammatory diseases in general. Understanding the mechanisms responsible for augmented ADH secretion during inflammation, monitoring patient sodium levels, and selecting the appropriate intravenous fluid treatment are important components that may lower the morbidity and mortality of patients in a critical condition.