Page 326 - Abstract Book KONIKA 18

Nephrology

P-NEP-015
Recurrent Hyponatremia in Pseudohypoaldosteronism: A Case Report

Ina Zarlina, Endang Lestari
Department of Child Health, Harapan Kita Women and Children Hospital, Jakarta, Indonesia

Abstract
Background Pseudohypoaldosteronism (PHA) type I is a genetic disorder resulting from mutations in the
subunits of the epithelial sodium channel that manifests as severe salt wasting, hyperkalemia, and metabolic
acidosis in infancy. Objective To demonstrate a case of pseudohypoaldosteronism in infant with recurrent
hyponatremia Case An 8-month-old, female infant was admitted to the hospital with presenting symptoms
of seizure, lethargy, vomiting and severe dehydration. Recent admission was noted with similar symptoms
but resolved with administration of IV fluid. Physical examination showed an ill appearing infant with
pale skin, poor perfusion, and sunken eyes. She had normal genitalia, without clitoromegaly. Laboratory
examination showed hyponatremia Na+ 123 mEq/L, hyperkalemia K+ 7.1 mEq/L, metabolic acidosis with
HCO3 14.6 mEq/L, base excess -8,7 mmol/L, elevated serum aldosterone 888 ng/dL (normal range supine
position:1.76-23,2 ng/dL), normal serum cortisol 3.1 ug/dl and high plasma renin activity 126.38 ng/mL/h
(normal range 0.25-5.82 ng/ml/h), and normal 17-hydroxyprogesterone 0.55 ng/ml (normal range ≤1.7 ng/
ml for term infants). She had a normal renal ultrasound. Treatment with hypertonic saline, hydration and
NaHCO3 normalized the electrolyte imbalances within 3 days. She was discharged home with oral sodium,
bicarbonate and rehydration solution. Conclusion Careful interpretation of aldosterone, renin and electrolyte
results maybe helpful in recognizing pseudohypoaldosteronism.
Keywords: Hyponatremia; pseudohypoaldosteronism.

P-NEP-016
Risk Factors of Short Stature in Children with Chronic Kidney Disease
at Mohammad Hoesin General Hospital Palembang

Indah Sari, Hertanti I. Lestari, Eka I. Fitriana
Department of Child Health, Faculty of Medicine Universitas Sriwijaya/Dr. Mohammad Hoesin General Hospital,
Palembang, South Sumatera, Indonesia

Abstract
Background Chronic kidney disease (CKD) has a negative effect on linear growth. Short stature in children
with CKD was most independently associated, younger-onset, stage of CKD, underweight, and treatments.
Objective To analyze the association between short stature and some risk factors in pediatric CKD at
Mohammad Hoesin General Hospital Palembang. Methods We reviewed the medical records from June
2016 to May 2021. Short stature was diagnosed if height/age <-2SD (aged <5years) or <P3 (aged 5-18 years)
using WHO or CDC growth chart, respectively. The studied risk factors were diseases onset, illness duration,
CKD stage, nutritional status, steroid treatments and cyclophosphamide treatments. Results There were 100
subjects; 57 were boys, the median age was 120 (18-204) months. Disease onset at <6 years old found in
17%, illness duration >2 years in 15%, CKD stage III-V in 29%, undernutrition in 17%, steroid treatments
in 67%, and cyclophosphamide treatment 26%. Short stature was diagnosed in 67 subjects. P values for all
risk factors were>0.05 with OR for diseases onset was 1.22 (95%CI 0.39 to 3.81), illness duration >2 years
2.18 (95%CI 0.57 to 8.34), CKD stage III-V 1.43 (95%CI 0.55 to 3.69), undernutrition 1.22 (95%CI 0.39
to 3.81), steroid treatments 1.53(95%CI 0.64 to 3.66), and cyclophosphamide treatment 1.15 (95%CI 0.44
to 3.04). Conclusion In this study, short stature presents in 67% of pediatric CKD patients. No significant
risk factors analyzed were found to be associated with short stature.
Keywords: chronic kidney disease; short stature; risk factors

278 KONIKA XVIII Abstract Book