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Symptomatic Hyponatremia in Nephrotic Syndrome

JOHN K. HURLEY, MD
Am J Dis Child. 1980;134(2):204-206. doi:10.1001/archpedi.1980.02130140074022.
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Hyponatremia may occur in children with nephrotic syndrome, usually when diuretic therapy has been used. Hyponatremia owing to inadequate salt intake, in the absence of diuretic treatment, is an unusual but probably overlooked cause.1.2 We report our experience in caring for a 2½-year-old boy with steroid-responsive nephrotic syndrome who had disorientation and hallucinations as a result of severe hyponatremia.

Report of a Case.—A male infant had classical nephrotic syndrome at age 21 months. He responded within two weeks to oral prednisone (2 mg/kg/day), with resolution of the edema and disappearance of the proteinuria. The prednisone dose was reduced during the next several weeks until a clinical relapse occurred. Again, daily prednisone treatment induced a remission, and a course of alternate-day prednisone was planned. While taking 40 mg of prednisone every other day, he had proteinuria (4 + ) without edema and, four days later, the prednisone dosage was increased to

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