Pathophysiology of Hyponatremia in Children

Frontiers in Pediatrics
Jakub Zieg

Abstract

Hyponatremia is a common electrolyte disorder in children. It is generally defined as plasma sodium of less than 135 mmol/l. Sodium homeostasis is essential for maintaining intravascular volume and is tightly linked to water balance. Plasma water volume is regulated mainly by the secretion of an antidiuretic hormone (ADH) and by the thirst mechanism. ADH is synthesized in the hypothalamus and stored in the posterior hypophysis. It binds to V2 receptors in the distal nephron and induces translocation of aquaporin water channels in the plasma membrane to retain water. There are two main types of receptors involved in the control of the body water balance-osmoreceptors and baroreceptors. Osmoreceptors reside in hypothalamus and respond to changes of extracellular fluid (ECF) osmolality. Baroreceptors are mechanoreceptors that sense blood pressure in the vessel wall. Response reflexes from baroreceptors influence sympathetic outflow, vessel tonus, and cardiac output. An increase of 1% of plasma osmolality may cause an increase in ADH levels, while the threshold of volume receptors for ADH secretion is higher. However, significant hypotension is a more potent stimulus for ADH secretion than increased osmolality. The main cause of pe...Continue Reading

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Citations

Sep 20, 2020·European Journal of Pediatrics·Adi PappoIrit Krause
Jun 10, 2018·BMC Endocrine Disorders·Helmuth G DörrUNKNOWN German Society of Pediatric Endocrinology and Diabetology
Mar 8, 2019·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Meral Torun BayramSalih Kavukçu
Oct 2, 2020·Clinical Chemistry·Aparna S ThombareElizabeth Sykes
Oct 31, 2021·Acta Paediatrica·Jakub Zieg
Apr 3, 2021·Pediatrics·Jane E DrianoAna L Creo

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