Evidence map›Paper›PMID 40220076›Full record

Observational studyPediatric nephrology (Berlin, Germany)2025

Impact of organ dysfunction on outcomes in pediatric hypernatremia: a retrospective observational study.

Ayumi Mihara, Kentaro Nishi, Itaru Hayakawa, Hiroki Kato, Norihiko Tsuboi, Masao Ogura, Hirotaka Chiba, Kentaro Ide, Shotaro Matsumoto, Kenji Ishikura and 2 more

Abstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in Pediatric nephrology (Berlin, Germany), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Thirst, sodium, and the hospitalized child: rethinking hypernatremia.Pediatric nephrology (Berlin, Germany) · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Ayumi MiharaCenter for Postgraduate Education and Training, National Center for Child Health and Development (NCCHD), 2-10-1 Okura, Setagaya-Ku, Tokyo, Japan.
Kentaro NishiDivision of Nephrology and Rheumatology, NCCHD, Tokyo, Japan. nishi-k@ncchd.go.jp.ORCID 0000-0002-3436-0392
Itaru HayakawaDivision of Neurology, NCCHD, Tokyo, Japan.
Hiroki KatoDivision of Critical Care Medicine, Department of Critical Care and Anesthesia, NCCHD, Tokyo, Japan.
Norihiko TsuboiDivision of Critical Care Medicine, Department of Critical Care and Anesthesia, NCCHD, Tokyo, Japan.
Masao OguraDivision of Nephrology and Rheumatology, NCCHD, Tokyo, Japan.
Hirotaka ChibaDepartment of Information Technology and Management, NCCHD, Tokyo, Japan.
Kentaro IdeDivision of Critical Care Medicine, Department of Critical Care and Anesthesia, NCCHD, Tokyo, Japan.
Shotaro MatsumotoDivision of Critical Care Medicine, Department of Critical Care and Anesthesia, NCCHD, Tokyo, Japan.
Kenji IshikuraDepartment of Pediatrics, Kitasato University School of Medicine, Kanagawa, Japan.ORCID 0000-0003-2692-6437
Koichi KameiDivision of Nephrology and Rheumatology, NCCHD, Tokyo, Japan.
Akira IshiguroCenter for Postgraduate Education and Training, National Center for Child Health and Development (NCCHD), 2-10-1 Okura, Setagaya-Ku, Tokyo, Japan.ORCID 0000-0002-3896-5313

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHypernatremia is associated with increased mortality risk in pediatric patients. However, its impact on outcomes remains unclear. This study aimed to clarify the clinical backgrounds of contemporary children with hypernatremia and identify prognostic factors, including the impact of organ dysfunction on mortality.

methodsWe conducted a retrospective observational study of children under 18 years of age with hypernatremia (serum sodium ≥ 150 mmol/L) at a tertiary pediatric hospital in Japan between December 2021 and May 2023. Patient characteristics, clinical course, mortality rate, and occurrence of intracranial hemorrhage were analyzed. Kaplan-Meier and multivariable Cox proportional hazard analyses assessed 180-day survival and mortality risk factors.

resultsOut of 9,208 children admitted, 116 (1.2%) with hypernatremia were finally analyzed; 91% had underlying chronic diseases and 91% had hospital-acquired hypernatremia. Before onset, 85% had medication related to hypernatremia, 80% received intravenous fluids, and 63% were managed with nil per os. Survival rates were 87.9%, 83.6%, and 81.9% at 30, 90, and 180 days from the onset of hypernatremia, respectively. Cox proportional hazard analysis reveal that four or more organ dysfunctions (odds ratio 5.83, 95%CI 1.92-17.7, P = 0.002) significantly correlated with death, after adjusting for intravenous fluids and peak sodium level. Two patients (2%) developed new subdural hematomas after the onset of hypernatremia.

conclusionsPediatric hypernatremia predominantly occurs in medically complex children and is mostly hospital-acquired. The number of organ dysfunctions is a strong predictor of mortality in children with hypernatremia.

Indexed as

HypernatremiaMultiple Organ FailureAdolescentChildChild, PreschoolFemaleHumansInfantInfant, NewbornIntracranial HemorrhagesJapanKaplan-Meier EstimateMalePrognosisRetrospective StudiesRisk FactorsChildrenHospital-acquired hypernatremiaMulti-organ dysfunctionPediatric hypernatremiaPediatric intensive care

Identifiers

PMID40220076

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.