TY - JOUR
T1 - Hyponatremia, hypo-osmolality, and seizures in children early post-kidney transplant
AU - Drake, Keri
AU - Nehus, Edward
AU - Goebel, Jens
N1 - Publisher Copyright:
© 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
PY - 2015
Y1 - 2015
N2 - Post-transplant seizures are uncommon in young kidney transplant recipients but can be harbingers of devastating outcomes such as cerebral edema and death. We reviewed all transplants performed at our institution from January 2013 to January 2014 and compared three patients who seized within 24 h post-transplant (cases) with the remaining 33 transplant recipients (controls). Records were reviewed for hyponatremia, hypocalcemia, hypomagnesemia, BUN clearance, osmolality shifts, and blood pressure control in the first 24 h post-transplant. All cases had more pronounced (p < 0.001) shifts in serum sodium and calculated serum osmolality, with their sodium decreasing by >15 mmol/L to nadir values of 124, 131, and 131 mmol/L, respectively. There were no differences in serum calcium corrected for hypoalbuminemia, serum magnesium, urine output, or blood pressure control between the groups. Our study suggests that mild hyponatremia and an acute decrease in serum osmolality are risk factors for potentially severe postoperative neurologic complications following kidney transplantation. Thus, peri-transplant management should be optimized to anticipate and prevent these abnormalities.
AB - Post-transplant seizures are uncommon in young kidney transplant recipients but can be harbingers of devastating outcomes such as cerebral edema and death. We reviewed all transplants performed at our institution from January 2013 to January 2014 and compared three patients who seized within 24 h post-transplant (cases) with the remaining 33 transplant recipients (controls). Records were reviewed for hyponatremia, hypocalcemia, hypomagnesemia, BUN clearance, osmolality shifts, and blood pressure control in the first 24 h post-transplant. All cases had more pronounced (p < 0.001) shifts in serum sodium and calculated serum osmolality, with their sodium decreasing by >15 mmol/L to nadir values of 124, 131, and 131 mmol/L, respectively. There were no differences in serum calcium corrected for hypoalbuminemia, serum magnesium, urine output, or blood pressure control between the groups. Our study suggests that mild hyponatremia and an acute decrease in serum osmolality are risk factors for potentially severe postoperative neurologic complications following kidney transplantation. Thus, peri-transplant management should be optimized to anticipate and prevent these abnormalities.
KW - disequilibrium syndrome
KW - hyponatremia
KW - pediatric renal transplantation
KW - seizures
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U2 - 10.1111/petr.12575
DO - 10.1111/petr.12575
M3 - Article
C2 - 26299753
AN - SCOPUS:84973441974
SN - 1397-3142
VL - 19
SP - 698
EP - 703
JO - Pediatric Transplantation
JF - Pediatric Transplantation
IS - 7
ER -