The Epidemiology of Hypernatremia in Hospitalized Children in a Secondary Hospital in Israel

Background: Hypernatremia is an uncommon pediatric electrolyte abnormality, and its true incidence is unknown. It is known that the most common cause of hypernatremia in admitted children is a dehydration status because of hypotonic gastrointestinal losses without replacement due to gastroenteritis or because of a systemic infection. Rotavirus is the most important viral cause of gastroenteritis among children worldwide in countries that have not adopted the universal rotavirus vaccine.

Methods: The study population included pediatric patients enrolled at the pediatric emergency department and the pediatric ward of a secondary medical center in Israel, who had laboratory evidence of hypernatremia during the years 2003-2020. Hypernatremia etiology was determined by surveying patient medical documents. For each patient we collected data regarding cause and severity of hypernatremia, stool culture results, vaccinations status, Rotavirus antigen, age and other important parameters.

Finidings: About 465 children aged 0-17 years had laboratory evidence of hypernatremia, 60% had a low intake cause. 36% had hypotonic gastrointestinal loss, of them about 83% because of acute gastroenteritis. About 26% of the acute gastroenteritis cases were due to Rotavirus infection. Renal loss causes make up 1.7% of all cases, and 1.5% of cases are due to sodium intoxication. We have found that the groups of GI and renal loss causes were related to mild hypernatremia (p value

Conclusion: In contrast to other epidemiologic studies, that found hypotonic gastrointestinal losses, most probably because of acute gastroenteritis, as the most common cause of hypernatremia, we have found, in this study, that low intake is the major cause of hypernatremia. In addition, in our study we’ve found that GI and renal loss causes were related to mild hypernatremia.