{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,23]],"date-time":"2025-08-23T05:20:35Z","timestamp":1755926435515,"version":"3.41.2"},"reference-count":21,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2020,3,5]],"date-time":"2020-03-05T00:00:00Z","timestamp":1583366400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100003810","name":"Hospital de Cl\u00ednicas de Porto Alegre","doi-asserted-by":"publisher","award":["17\u20100334"],"award-info":[{"award-number":["17\u20100334"]}],"id":[{"id":"10.13039\/501100003810","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Transplantation"],"published-print":{"date-parts":[[2020,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Biliary atresia is the number one cause of cirrhosis and liver transplantation in children. Hyponatremia is the most important electrolytic disturbance observed in decompensated cirrhosis. Studies of hyponatremia in cirrhotic children are scarce and those that exist have defined hyponatremia as serum sodium\u00a0&lt;\u00a0130\u00a0mEq\/L lasting for at least 7\u00a0days.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We evaluated transplant\u2010free survival (Kaplan\u2010Meier) of children with cirrhosis due to biliary atresia and serum sodium\u00a0&lt;\u00a0130\u00a0mEq\/L persisting for 1, 2\u20106, and \u22657\u00a0days. This was a single\u2010center, historical cohort that included all patients aged\u00a0\u2264\u00a018\u00a0years on a liver transplantation waiting list.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We studied 128 patients. The overall frequency of hyponatremia was 30.5% (39\/128). Thirteen patients (10.2%) had hyponatremia when put on the list, and 20.3% developed it during follow\u2010up. The Kaplan\u2010Meier overall transplant\u2010free survival rate was 83.3%. Patients with persistent hyponatremia for at least two days had the lowest transplant\u2010free survival. Glomerular filtration rate (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.00, RR\u00a0=\u00a00.96, IC 95%\u00a0=\u00a00.94\u20100.99), BMI\/age Z\u2010score (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.02, RR\u00a0=\u00a00.59, IC 95%\u00a0=\u00a00.39\u20100.91), INR (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.00, RR\u00a0=\u00a01.43, IC 95%\u00a0=\u00a01.17\u20101.74), and serum sodium (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.04, RR\u00a0=\u00a00.91, IC 95%\u00a0=\u00a00.84\u20100.99) were independently associated with transplant\u2010free survival. We did not observe any difference in mortality prediction after adding sodium to the original PELD score.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We conclude that persistent hyponatremia lasting at least two days may herald poor prognosis for children with cirrhosis due to biliary atresia.<\/jats:p><\/jats:sec>","DOI":"10.1111\/petr.13687","type":"journal-article","created":{"date-parts":[[2020,3,5]],"date-time":"2020-03-05T10:47:24Z","timestamp":1583405244000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Hypervolemic hyponatremia and transplant\u2010free survival in children with cirrhosis due to biliary atresia"],"prefix":"10.1111","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5345-3287","authenticated-orcid":false,"given":"Renata","family":"Silva Duarte dos Santos","sequence":"first","affiliation":[{"name":"Programa de P\u00f3s\u2010Gradua\u00e7\u00e3o Sa\u00fade da Crian\u00e7a e do Adolescente Universidade Federal do Rio Grande do Sul Porto Alegre Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlos Oscar","family":"Kieling","sequence":"additional","affiliation":[{"name":"Unidade de Gastroenterologia e Hepatologia Pedi\u00e1trica Programa de Transplante Hep\u00e1tico Infantil Hospital de Cl\u00ednicas de Porto Alegre. Servi\u00e7o de Pediatria Porto Alegre Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marina Rossato","family":"Adami","sequence":"additional","affiliation":[{"name":"Unidade de Gastroenterologia e Hepatologia Pedi\u00e1trica Programa de Transplante Hep\u00e1tico Infantil Hospital de Cl\u00ednicas de Porto Alegre. Servi\u00e7o de Pediatria Porto Alegre Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Renata Rostirola","family":"Guedes","sequence":"additional","affiliation":[{"name":"Unidade de Gastroenterologia e Hepatologia Pedi\u00e1trica Programa de Transplante Hep\u00e1tico Infantil Hospital de Cl\u00ednicas de Porto Alegre. Servi\u00e7o de Pediatria Porto Alegre Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9788-5428","authenticated-orcid":false,"given":"Sandra Maria Gon\u00e7alves","family":"Vieira","sequence":"additional","affiliation":[{"name":"Programa de P\u00f3s\u2010Gradua\u00e7\u00e3o Sa\u00fade da Crian\u00e7a e do Adolescente Universidade Federal do Rio Grande do Sul Porto Alegre Brazil"},{"name":"Unidade de Gastroenterologia e Hepatologia Pedi\u00e1trica Programa de Transplante Hep\u00e1tico Infantil Hospital de Cl\u00ednicas de Porto Alegre. Servi\u00e7o de Pediatria Porto Alegre Brazil"},{"name":"Departamento de Pediatria Universidade Federal do Rio Grande do Sul Porto Alegre Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,3,5]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.12688\/f1000research.16732.1"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.29905"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1080\/17474124.2017.1367662"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0000000000001841"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/MEG.0000000000001046"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-3046.2009.01142.x"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.26776"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-017-4597-8"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/lt.25327"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2013.110"},{"key":"e_1_2_9_12_1","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1159\/000318927","volume-title":"Ascites, Hyponatremia, and Hepatorenal Syndrome, Progress in Treatment","author":"Heuman DM","year":"2011"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2010.05.004"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/gastro\/gox010"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12072-018-9894-6"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v25.i8.888"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.5455\/medarh.2016.70.48-52"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroscience.2010.03.042"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2013.07.006"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2014.12.029"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0000000000002130"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2018.2541"}],"container-title":["Pediatric Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fpetr.13687","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/petr.13687","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/petr.13687","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/petr.13687","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,30]],"date-time":"2023-08-30T10:48:18Z","timestamp":1693392498000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/petr.13687"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,3,5]]},"references-count":21,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2020,5]]}},"alternative-id":["10.1111\/petr.13687"],"URL":"https:\/\/doi.org\/10.1111\/petr.13687","archive":["Portico"],"relation":{},"ISSN":["1397-3142","1399-3046"],"issn-type":[{"type":"print","value":"1397-3142"},{"type":"electronic","value":"1399-3046"}],"subject":[],"published":{"date-parts":[[2020,3,5]]},"assertion":[{"value":"2019-08-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-02-03","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-03-05","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e13687"}}