Frequency and clinical characteristics of hyponatremia in patients presenting to the pediatric emergency department: a retrospective single-center study

Abstract

Objective: This study aimed to evaluate the demographic, clinical, and laboratory characteristics of pediatric patients with hyponatremia presenting to the pediatric emergency department and to identify the high-risk population and predictors of hospital admission. Materials and Methods: This retrospective study included 1026 patients aged <18 years who were admitted to the pediatric emergency department between June 1, 2025, and December 31, 2025, and had serum sodium (Na) level<135 mEq/L. Patients were grouped and compared according to age and serum Na levels, and factors associated with hospitalization and moderate-to-severe hyponatremia were analyzed. Results: 58% of patients were female and 42% were male; the mean age was 6.58 ± 5.08 years. Hyponatremia was frequently observed in the 0-5 year age group (n=517, 50.38%) and was mild in severity (93.5%). Hyponatremia was most frequently observed during infection/sepsis (n=317, 30.9%). When etiological predictors of moderate-to-severe hyponatremia were analyzed with acute gastroenteritis as a reference, it was found that the presence of metabolic disease and inappropriate ADH secretion increased the risk of moderate-to-severe hyponatremia; the presence of infection/sepsis as an etiology decreased the risk of moderate-to-severe hyponatremia. When etiological conditions associated with hospitalization were analyzed with acute gastroenteritis as a reference, it was found that the probability of hospitalization increased in the presence of acute abdomen, metabolic disease, renal disease/CKD, inappropriate ADH secretion, infection/sepsis, and other etiologies. Conclusion: Hyponatremia is an important biomarker reflecting the severity of the underlying disease and directly affecting clinical management and prognosis.

Keywords

• Hyponatremia
• pediatric emergency
• electrolyte imbalance
• hospitalization

Ethical Statement

This study was approved by the Mersin University Health Sciences Research Ethics Committee with decision number 2026/218.

Çocuk acil servisine başvuran hastalarda hiponatreminin sıklığı ve klinik özellikleri: retrospektif tek merkezli çalışma

Abstract

Amaç: Çocuk acil servisine başvuran ve hiponatremi saptanan hastaların demografik, klinik ve laboratuvar özelliklerinin değerlendirilerek hastane yatışı ve orta-ağır hiponatremi ile ilişkili faktörlerin belirlenmesi amaçlandı. Gereç ve Yöntem: Bu retrospektif çalışmaya, 1 Haziran 2025 ile 31 Aralık 2025 tarihleri arasında, çocuk acil servisine başvuran ve serum sodyum (Na) düzeyi <135 mEq/L olan 18 yaş altı 1026 hasta dahil edildi. Hastalar yaşa ve serum Na düzeylerine göre gruplanarak karşılaştırıldı, hastane yatışı ve orta-ağır hiponatremi ile ilişkili faktörler analiz edildi. Bulgular: Hastaların %58’i kız, %42’si erkek; yaş ortalaması 6.58±5.08 yıl idi. Hiponatreminin en sık 0-5 yaş grubunda (n=517, %50.4) ve hafif şiddette olduğu (%93.5) görüldü. Hiponatremi en sık enfeksiyon/sepsis sırasında (n=317, %30.9) izlendi. Orta-ağır hiponatreminin etyolojik prediktörleri akut gastroenterit referans alınarak analiz edildiğinde, etyolojide metabolik hastalık ve uygunsuz ADH salınımı varlığının orta-ağır hiponatremi riskini artırdığı; etyolojide enfeksiyon/sepsis varlığının orta-ağır hiponatremi riskini azalttığı görüldü. Hastane yatışı ile ilişkili etyolojik durumlar akut gastroenterit referans alınarak analiz edildiğinde, etyolojide akut batın, metabolik hastalık, renal hastalık/KBY, uygunsuz ADH salınımı, enfeksiyon/sepsis ve diğer etyolojiler varlığında hastaneye yatış olasılığının arttığı görüldü. Sonuç: Hiponatremi etyolojideki hastalığın ciddiyetini yansıtan ve klinik yönetimi, prognozu doğrudan etkileyen önemli bir biyobelirteçtir.

Keywords

• Hiponatremi
• çocuk acil
• elektrolit bozukluğu
• hastaneye yatış

Ethical Statement

Bu çalışma için Mersin Üniversitesi Sağlık Bilimleri Araştırma Etik Kurulundan 2026/218 sayılı kurul kararı ile etik onay alınmıştır.

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