Transient secondary pseudo-hypoaldosteronism in infants with urinary tract infections: systematic literature review.

Details

Serval ID
serval:BIB_BA3676012753
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Transient secondary pseudo-hypoaldosteronism in infants with urinary tract infections: systematic literature review.
Journal
European journal of pediatrics
Author(s)
Betti C., Lavagno C., Bianchetti M.G., Kottanattu L., Lava SAG, Schera F., Lacalamita M.C., Milani G.P.
ISSN
1432-1076 (Electronic)
ISSN-L
0340-6199
Publication state
Published
Issued date
10/2024
Peer-reviewed
Oui
Volume
183
Number
10
Pages
4205-4214
Language
english
Notes
Publication types: Journal Article ; Systematic Review
Publication Status: ppublish
Abstract
Infants with a congenital anomaly of the kidney and urinary tract sometimes present with hyponatremia, hyperkalemia, and metabolic acidosis due to under-responsiveness to aldosterone, hereafter referred to as secondary pseudo-hypoaldosteronism. The purpose of this report is to investigate pseudo-hypoaldosteronism in infant urinary tract infection. A systematic review was conducted following PRISMA guidelines after PROSPERO (CRD42022364210) registration. The National Library of Medicine, Excerpta Medica, Web of Science, and Google Scholar without limitations were used. Inclusion criteria involved pediatric cases with documented overt pseudo-hypoaldosteronism linked to urinary tract infection. Data extraction included demographics, clinical features, laboratory parameters, management, and course. Fifty-seven reports were selected, detailing 124 cases: 95 boys and 29 girls, 10 months or less of age (80% of cases were 4 months or less of age). The cases exhibited hyponatremia, hyperkalemia, acidosis, and activated renin-angiotensin II-aldosterone system. An impaired kidney function was found in approximately every third case. Management included antibiotics, fluids, and, occasionally, emergency treatment of hyperkalemia, hyponatremia, or acidosis. The recovery time averaged 1 week for electrolyte, acid-base imbalance, and kidney function. Notably, anomalies of the kidney and urinary tract were identified in 105 (85%) cases.
This review expands the understanding of overt transient pseudo-hypoaldosteronism complicating urinary tract infection. Management involves antimicrobials, fluid replacement, and consideration of electrolyte imbalances. Raising awareness of this condition within pediatric hospitalists is desirable.
• Infants affected by a congenital anomaly of the kidney and urinary tract may present with clinical and laboratory features resembling primary pseudo-hypoaldosteronism. • Identical features occasionally occur in infant urinary tract infection.
• Most cases of secondary pseudo-hypoaldosteronism associated with a urinary tract infection are concurrently affected by a congenital anomaly of the kidney and urinary tract. • Treatment with antibiotics and parenteral fluids typically results in the normalization of sodium, potassium, bicarbonate, and creatinine within approximately 1 week.
Keywords
Humans, Urinary Tract Infections/complications, Urinary Tract Infections/diagnosis, Infant, Hypoaldosteronism/complications, Hypoaldosteronism/diagnosis, Hyperkalemia/etiology, Hyperkalemia/diagnosis, Hyponatremia/etiology, Hyponatremia/diagnosis, Female, Male, Acidosis/etiology, Acidosis/diagnosis, Infant, Newborn, Acidosis, Hyperkalemia, Hyponatremia, Under-responsiveness to aldosterone, Urinary tract infection
Pubmed
Web of science
Open Access
Yes
Create date
12/07/2024 13:36
Last modification date
24/09/2024 7:19
Usage data