Pediatric Nephrology

, Volume 21, Issue 7, pp 1048–1049 | Cite as

Neurological complications from dysnatremias in children: a different point of view

  • Patricio E. RayEmail author
Letter to the Editors


In a recent review article, Moritz and Ajus [1] have suggested that the routine administration of hypotonic fluids, as proposed by Holliday et al. [2], can result in fatal hyponatremic encephalopathy. To support this statement they discussed the death of a 3-week-old child who was treated in the setting of dehydration with a bolus of 0.9% NaCl followed by maintenance hypotonic fluids. They also cited the death of 16 children who developed severe hyponatremia due to extensive extra renal losses of electrolyte-containing fluids, and were not treated in a timely manner even in the presence of obvious symptoms [3]. It appears that Moritz and Ajus have misinterpreted the teachings of Holliday et al. [2]. Holliday et al. recommended the use of hypotonic fluids to replace ongoing physiological insensible and urinary water losses when oral intake is suspended under well-defined clinical conditions [2]. They defined the term 'maintenance therapy', and clarified that (1) the formula...


Serum Sodium Hypertonic Saline Serum Sodium Concentration Maintenance Fluid Severe Hyponatremia 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© IPNA 2006

Authors and Affiliations

  1. 1.Children's Research Institute & Children's National Medical CenterThe George Washington UniversityWashingtonUSA
  2. 2.Director Renal Research, Room R-211Children's Research Institute, Children's National Medical CenterWashingtonUSA

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