Abstract
Hyponatremia is not rare in cystic fibrosis and might be due to several mechanisms. An endocrine and renal imbalance in water and salt homeostasis was suggested. To address this hypothesis, we assessed the urinary concentrating and diluting ability in 12 cystic fibrosis patients (6 females, 6 males) and in two control groups: 14 children with pneumonia (9 females, 5 males) and in 13 healthy children (9 females, 4 males). Renal concentrating ability was evaluated following overnight water deprivation. Urine osmolality was not significantly different between groups. Renal diluting ability was assessed by means of a water-load test. This provoked a decrease in urine osmolality, as well as an increase in diuresis and solute-free water excretion. These changes were comparable among groups.
Conclusion: Children with cystic fibrosis show a preserved renal concentrating and diluting capacity. A generalized endocrine and renal imbalance in water and salt homeostasis therefore appears unlikely.
What is Known: •Hyponatremia sometimes occurs in cystic fibrosis. What is New: •Osmoregulation is normal in cystic fibrosis. |
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Funding
This work was supported by the grant from Russian Science Foundation, project 18-15-00358, Saint-Petersburg, Russia (to Yu. V. Natochin).
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Yury V. Natochin conceptualized and designed the study, coordinated and supervised data collection, and reviewed and revised the manuscript. Alla A. Kuznetsova, Anastasia V. Prokopenko, and Anna S. Marina accommodated data collection, analyzed data, and reviewed the manuscript. Gregorio P. Milani, Sebastiano A.G. Lava, Yury V. Natochin, and Anna S. Marina wrote the paper. All authors approved the final manuscript as submitted and agreed to be accountable for all aspects of the work.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The Regional Committee of the St. Petersburg State Paediatric Medical University approved the study protocol.
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Natochin, Y.V., Kuznetsova, A.A., Prokopenko, A.V. et al. Osmoregulation in children with cystic fibrosis. Eur J Pediatr 179, 835–838 (2020). https://doi.org/10.1007/s00431-019-03550-1
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DOI: https://doi.org/10.1007/s00431-019-03550-1