Kaninde A, Grace ML, Joyce C, Taylor NF, Ghataore L, Riordan MF, O’Grady MJ, O’Connell SM. The incidence of transient infantile pseudohypoaldosteronism in Ireland: A prospective study.
Acta Paediatr 2021;
110:1257-1263. [PMID:
33245792 DOI:
10.1111/apa.15688]
[Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 08/31/2020] [Accepted: 11/23/2020] [Indexed: 01/20/2023]
Abstract
AIM
To review the clinical course, outcome and incidence of infantile salt wasting associated with urinary tract infection (UTI) and/or urinary tract malformation (UTM) over a two-year surveillance period on the island of Ireland.
METHODS
A two-year (2013-14) prospective surveillance undertaken via the Irish and Ulster Paediatric Surveillance Units. Monthly prepaid postcards were circulated to consultant paediatricians (n = 260) at all paediatric units on the island of Ireland. Infants under one year of age presenting for the first time with hyponatraemia (Na < 130 mmol/L) and/or hyperkalaemia (K > 5.0 mmol/L) associated with urosepsis/UTM were reported.
RESULTS
All 7 reported patients (6 male) had culture-proven UTI, and 5 (71%) also had an underlying UTM (one diagnosed antenatally). Four (57%) patients had a documented elevated serum aldosterone supporting secondary pseudohypoaldosteronism (PHA) as the underlying diagnosis. Data on aldosterone were not reported in the other 3 patients, but clinical features were suggestive of secondary PHA. The estimated incidence for the Irish population of transient PHA is 1 per 13,200 total live births per year.
CONCLUSIONS
Salt wasting is a rare complication of UTI, especially if associated with underlying UTM. Boys appear to be at particular risk.
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