Although a low urine sodium of 500 mOsm/kg), persistence of high urine sodium concentrations may be useful to predict poor response to fluid restriction in SIADH. In both cases, fluid administration and/or consumption worsened the hyponatremia. The first patient had hyponatremia from traumatic brain injury (TBI) while the second case had a history of recurrent SIADH triggered by various causes including gastritis. We present two cases of severe hyponatremia secondary to syndrome of inappropriate secretion of antidiuretic hormone (SIADH) with very high urine sodium concentrations (>130 mmol/L). 2Department of Endocrinology, Changi General Hospital, Singapore, Singapore.1Department of Endocrinology, Sengkang General Hospital, Singapore, Singapore.Our study tries to show that urine spot sodium is not correlated with sodium intake, in fasting ill group it varied between 58 and 88 mEq/L, while in normal nonfasting children it was high between 142 and 168 mEq/L, while UNa/Cr in ill children is higher than control group with a wide range of changes and overlap with control grou P values compare to spot urine sodium.Lynette Mei Yi Lee 1 *, Sarah Ying Tse Tan 2 and Wann Jia Loh 2 Although in other studies the benefits of spot urine test has been investigated, spot UNa/Cr was attributed to hypertension, this ratio (UNa/Cr randomly) is also correlated to 24 h sodium excretion and can be correlated positively to gastric cancer risk stages. Sodium ion plays important role in blood pressure regulation, but sodium intake rarely used in clinical practice because of 24 h urine collection is cumbersome, while spot urine test can be desirable, although sodium excretion in random can be varied in different time of collection but in mid afternoon and early morning are more correlative with 24 h urine sodium excretion but in renal diseases estimation of 24 h sodium excretion by spot urine test cannot be reliable.Įighty-three percent of daily dietary intake can be excreted in urine, it was shown that 24 h sodium can be comparable with overnight collection, but not with spot urine test. Urine sodium is low (lower part), while UNa/Cr is high and overlapped with control group (upper part) There is not any correlation between urine sodium and received total sodium in grams per 24 h (r = −0.06, P = 0.7) or total sodium (mEq) per 24 h (r = −0.06, P = 0.7) there is not any correlation between urine sodium/creatinine (UNa/Cr) and total sodium intake in gram (r = −0.3, P = 0.1) and millie quivalent (r = −0.26, P = 0.1). Age of ill and starved children was between 24 and 156 months 66 ± 4 months, daily sodium intake was varied from 2.8 ± 0.7 g (minimum 2 g, maximum 4 g) or 48 ± 12 mEq. In this study, we try to find urine sodium changes in children who are receiving standard values of sodium (3 mEq/dL of maintenance fluid) as compared to healthy children who intake usual Iranian diet. Measurement of urine sodium is a vital matter which can show integrity of tubular function for reabsorption and low urine sodium indicate intact tubular function for sodium conservation, while high urine sodium may signify salt wasting causes and classification of hyponatremia, the reference range for urine sodium is 40–220 mEq/L/24 h.
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