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Aetiology

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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Water overload:

  • secondary to ADH secretion commonly occuring in hyaline membrane disease, ventilation pneumothorax or intraventricular haemorrhage
  • in the first 24 hours due to excess fluid administration to the mother or child
  • in acute renal failure before fluid restriction

Increased sodium losses:

  • excess renal loss in the preterm baby is exacerbated by diuretic or aminophylline therapy
  • inherited tubular disorders
  • adrenal insufficiency - with dehydration and hyperkalaemia
  • excess gastrointestinal losses in gastroenteritis

Inadequate sodium intake:

  • late hyponatremia may be caused by inadequate sodium content during intravenous nutrition
  • in the preterm after 2 weeks of low solute breast milk or formula. Preterm milk has a higher sodium concentration and should not be used after 4 to 6 weeks unless high sodium losses continue

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