Prevalence of hyponatremia in children admitted at Kenyatta National Hospital with pneumonia

Abstract

Background Pneumonia remains the leading single cause of childhood mortality. It’s associated with several complications the commonest being hyponatremia. Studies done in the western countries have reported a high prevalence of hyponatremia, an indicator also of disease severity No study has been done to evaluate the prevalence of hyponatremia in children admitted at the Kenyatta National Hospital. Objectives The objectives of this study were; to determine the prevalence of hyponatremia in children admitted with pneumonia at KNH and to describe the socio-demographic and clinical characteristics of children found to have hyponatremia. Methodology A descriptive cross-sectional study was carried out at KNH on children aged 2months to 12years admitted with pneumonia. Those who met the inclusion criteria were recruited. History and physical examination was done to confirm diagnosis and classify the severity of pneumonia. A 2ml blood sample was then withdrawn from the patient and taken to the laboratory for electrolyte analysis. Results A total of 135 pediatric patients admitted at KNH were reviewed. Prevalence of hyponatremia was 71.9 %( 97/135). Most patient had severe hyponatremia 40.6 %( 39/97). Hyponatremia was significantly associated with high temperatures (39.00c-41.10c), (OR=6.60 [95%CI: 1.62-26.92]; p=0.009. There was a significant association between having very severe pneumonia and hyponatremia (OR=3.45 [95%CI: 1.56-7.69]; p=0.002. A high proportion of children having very severe pneumonia also had hyponatremia (83.8%) compared to those with severe pneumonia (59.7%). Having hypokalemia was significantly associated with hyponatremia (OR=4.08 [95%CI: 1.44-11.57]; p=0.008. A high proportion of children with hypokalemia had hyponatremia (87.2%) compared to those with normal potassium level (62.5%). Conclusion There is a high prevalence of hyponatremia in children admitted with pneumonia at KNH. Hyponatremia is an indicator of severe illness and use of hypotonic intravenous solutions is associated with development of hyponatremia . RecommendationsAll patients admitted with pneumonia should have electrolyte levels analyzed and appropriate management instituted. Caution should be exercised when giving intravenous fluids to children with pneumonia.