Prevalence and Factors Associated With Hyponatremia Among Paediatric Oncology Patients at Kenyatta National Hospital- a Hospital-based Cross sectional Study

Abstract

Introduction: Hyponatremia is an independent predictive factor of survival in cancer patients; and its prompt correction is imperative. Data on the prevalence and factors associated with hyponatremia among paediatric oncology patients in Africa are scarce. Objective: To determine the prevalence and factors associated with hyponatremia and the proportion of promptly corrected hyponatremia among paediatric oncology patients at Kenyatta National Hospital. Methodology: A hospital-based cross-sectional study. The proportion of children with hyponatremia was estimated and a 95% confidence interval provided. Multivariable logistic regression analysis was used to determine factors associated with hyponatremia. Results: The overall prevalence of hyponatremia was 43.3% (95% CI 38.55%- 55.78%). Of these, approximately 23% had mild hyponatremia, 18% had moderate hyponatremia and 2.7% had severe hyponatremia. Only 29% of those patients having moderate and severe hyponatremia received prompt correction. Age, BMI for age, current chemotherapeutic medications, chemotherapy cycle and TPN were not statistically significant in this study. Conclusions: There is a high prevalence of hyponatremia among paediatric cancer patients receiving care at KNH and approximately two thirds of the paediatric cancer patients with moderate and severe hyponatremia seeking care at KNH do not receive prompt correction for their hyponatremia. Recommendations: Paediatric cancer patients should be given more attention and routinely be screened for hyponatremia and other electrolyte disorders. Timely intervention should be instituted for hyponatremia if present in these paediatric cancer patients. Larger studies assessing factors associated with hyponatremia and outcome of paediatric oncology patients with hyponatremia are needed in our set-up.