{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,3,7]],"date-time":"2025-03-07T05:26:18Z","timestamp":1741325178669,"version":"3.38.0"},"reference-count":14,"publisher":"Georg Thieme Verlag KG","issue":"05","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Preterm infants often develop relative adrenal insufficiency (RAI) not only within the early neonatal period but also beyond this period. RAI is commonly accompanied by hyponatremia, but the pathogenesis of hyponatremia with RAI has not been clarified. This study aimed to investigate the pathophysiology of hyponatremia in infants with RAI.<\/jats:p><jats:p>This is a single-centered retrospective cohort study. Preterm infants born at &lt;30 weeks of gestation or birth weight &lt;1,000\u2009g were enrolled. They were divided into the RAI group and the non-RAI group. The data of serum and urine examination, the amount of sodium intake, and fractional excretion of sodium (FENa) were compared between the two groups. In the RAI group, data before and after the administration of hydrocortisone were also compared.<\/jats:p><jats:p>Sixteen infants in the RAI group and 35 infants in the non-RAI group were included in the analysis. In the RAI group, hyponatremia was common and preceded other clinical symptoms, such as oliguria and decreased blood pressure, therefore, hyponatremia with RAI was not likely to be caused by dilution due to oliguria. There was no difference in the FENa between the two groups (adjusted for postconceptional age at examination), therefore, it is not likely that hyponatremia with RAI was mainly caused by excessive renal sodium loss. Since sodium intake was rather higher in the RAI group than in the non-RAI group, it is unlikely that insufficient sodium supplementation was the cause of RAI. Hyponatremia with RAI was considered to be likely caused by vascular hyperpermeability.<\/jats:p><jats:p>Hyponatremia is a common symptom among preterm infants with RAI and its pathogenesis can be vascular hyperpermeability.<\/jats:p>","DOI":"10.1055\/a-2413-0844","type":"journal-article","created":{"date-parts":[[2024,9,11]],"date-time":"2024-09-11T23:02:41Z","timestamp":1726095761000},"page":"593-598","source":"Crossref","is-referenced-by-count":0,"title":["Pathophysiology of Hyponatremia in Preterm Infants with Relative Adrenal Insufficiency after the Early Neonatal Period"],"prefix":"10.1055","volume":"42","author":[{"given":"Mitsuyo","family":"Akita","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seiichi","family":"Tomotaki","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shintaro","family":"Hanaoka","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryosuke","family":"Araki","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kouji","family":"Motokura","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yutaro","family":"Tomobe","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroko","family":"Tomotaki","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kougoro","family":"Iwanaga","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Junko","family":"Takita","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masahiko","family":"Kawai","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2024,9,30]]},"reference":[{"issue":"05","key":"ref1","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1038\/pr.2012.114","article-title":"Trends in morbidity and mortality among very-low-birth-weight infants from 2003 to 2008 in Japan","volume":"72","author":"S Kusuda","year":"2012","journal-title":"Pediatr Res"},{"issue":"02","key":"ref2","doi-asserted-by":"crossref","first-page":"F119","DOI":"10.1136\/adc.2002.021972","article-title":"Transient adrenocortical insufficiency of prematurity and systemic hypotension in very low birthweight infants","volume":"89","author":"P C Ng","year":"2004","journal-title":"Arch Dis Child Fetal Neonatal Ed"},{"issue":"06","key":"ref3","doi-asserted-by":"crossref","first-page":"F571","DOI":"10.1136\/archdischild-2016-311289","article-title":"Adrenocortical insufficiency and refractory hypotension in preterm infants","volume":"101","author":"P C Ng","year":"2016","journal-title":"Arch Dis Child Fetal Neonatal Ed"},{"issue":"04","key":"ref4","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1111\/ped.13242","article-title":"Late-onset circulatory collapse of prematurity","volume":"59","author":"M Kawai","year":"2017","journal-title":"Pediatr Int"},{"issue":"11","key":"ref5","doi-asserted-by":"crossref","first-page":"751","DOI":"10.1038\/jp.2010.41","article-title":"Clinical characterization and long-term prognosis of neurological development in preterm infants with late-onset circulatory collapse","volume":"30","author":"H Nakanishi","year":"2010","journal-title":"J Perinatol"},{"issue":"06","key":"ref6","doi-asserted-by":"crossref","first-page":"686","DOI":"10.1203\/PDR.0b013e31816c8fcc","article-title":"Comparison of serum cortisol concentrations in preterm infants with or without late-onset circulatory collapse due to adrenal insufficiency of prematurity","volume":"63","author":"K Masumoto","year":"2008","journal-title":"Pediatr Res"},{"issue":"06","key":"ref7","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1016\/j.pedneo.2019.09.005","article-title":"Late-onset glucocorticoid-responsive circulatory collapse in premature infants","volume":"60","author":"S Iijima","year":"2019","journal-title":"Pediatr Neonatol"},{"issue":"01","key":"ref8","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1542\/peds.95.1.120","article-title":"Evidence of early adrenal insufficiency in babies who develop bronchopulmonary dysplasia","volume":"95","author":"K L Watterberg","year":"1995","journal-title":"Pediatrics"},{"issue":"03","key":"ref9","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1620\/tjem.235.241","article-title":"Late-onset glucocorticoid-responsive circulatory collapse in preterm infants: clinical characteristics of 14 patients","volume":"235","author":"T Shimokaze","year":"2015","journal-title":"Tohoku J Exp Med"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"660","DOI":"10.1111\/cen.13446","article-title":"CRH stimulation tests for the infants with relative adrenal insufficiency","volume":"87","author":"K Iwanaga","year":"2017","journal-title":"Clin Endocrinol (Oxf)"},{"issue":"S 02","key":"ref11","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1046\/j.1464-410X.1998.0810s2033.x","article-title":"Development of glomerular filtration and tubular sodium reabsorption in the human fetus and newborn","volume":"81","author":"G B Haycock","year":"1998","journal-title":"Br J Urol"},{"issue":"05","key":"ref12","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1136\/adc.58.5.335","article-title":"Sodium homeostasis in term and preterm neonates. I. Renal aspects","volume":"58","author":"J Al-Dahhan","year":"1983","journal-title":"Arch Dis Child"},{"issue":"45","key":"ref13","first-page":"757","article-title":"The nomenclature, definition and distinction of types of shock","volume":"115","author":"T Standl","year":"2018","journal-title":"Dtsch Arztebl Int"},{"issue":"05","key":"ref14","doi-asserted-by":"crossref","first-page":"582","DOI":"10.1111\/ped.12114","article-title":"Hemodynamic analysis in infants with late-onset circulatory collapse","volume":"55","author":"Y Washio","year":"2013","journal-title":"Pediatr Int"}],"container-title":["American Journal of Perinatology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2413-0844.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,6]],"date-time":"2025-03-06T23:56:45Z","timestamp":1741305405000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2413-0844"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,11]]},"references-count":14,"journal-issue":{"issue":"05","published-online":{"date-parts":[[2025,3,6]]},"published-print":{"date-parts":[[2025,4]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2413-0844","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0735-1631","1098-8785"],"issn-type":[{"type":"print","value":"0735-1631"},{"type":"electronic","value":"1098-8785"}],"subject":[],"published-other":{"date-parts":[[2024,9,11]]},"published":{"date-parts":[[2024,9,11]]}}}