القيمة التشخيصية لنقص صوديوم الدم في حالات التهاب الحويضة و الكلية الحاد عند الأطفال

الملخص EN

Objective: Is to know the importance of hyponatremia as biological marker in early diagnosis of acute pyelonephritis, and the association between hyponatremia and inflammatory markers.

Methods: The study involves 75 patients with acute pyelonephritis for the first time, whose age between 3-13 year and 75 control patients who have fever without acute pyelonephritis in one year 2013-2014 in Al-Assad Hospital in Latakia, Syria.

Laboratory tests: White blood cell count, C-reactive protein, serum and urine sodium concentration, and urine culture (culture growing >100.000 colonies on clean-catch samples was required to establish diagnosis of pyelonephritis) were determined in both groups.

Radiologic investigations: (renal ultrasonography, VCUG) were performed.

Results: In patients with acute pyelonephritis, the inflammatory markers (white blood cell count, neutrophils count, and C-reactive protein) were significantly higher than in those without pyelonephritis (p<0.001), serum sodium concentration was negatively correlated with WBC count (r=-0.48, p=0.01), absolute neutrophils count (r=-0.25, p=0.01), and CRP (r=-0.40, p=0.01) in patients with acute pyelonephritis.

Serum sodium concentration return to normal value after 48 hours of treatment with antibiotics.

The radiologic investigations were normal.

Conclusions: Our study indicate that hyponatremia may be a substantial «inflammatory» marker, and is significantly correlated with the degree of inflammation in children with acute pyelonephritis.