Factors Influencing Hyponatremia in Hospitalized Diabetic Patients- A Cross Sectional Study

Ahmed, Sheikh Salahuddin; Nur, Fazle; Ullah, Rahamat; Mamun, Abdullah Al; Chowdhury, Tauhidul Islam; Laila, Tarafdar Runa; Khan, Abdul Mahid

doi:10.3329/medtoday.v26i1.21301

Cited by 3 publications

(3 citation statements)

References 19 publications

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“… 6 , 24 , 25 Due to the osmotically active nature of glucose, diabetes can cause a drop in serum Na + levels by causing a dilution effect that moves water from intracellular to extracellular compartments. 26 However, our study finding was lower than studies done in Bangladesh (63.3%) and Kerala (75%). 27 , 28 The difference could be those studies done in admitted diabetic patients included diuretics medication takers and the majority of participants had diabetic nephropathy, both of which are major contributors to hyponatremia.…”

Section: Discussioncontrasting

confidence: 89%

Assessment of Electrolyte Imbalance and Associated Factors Among Adult Diabetic Patients Attending the University of Gondar Comprehensive Specialized Hospital, Ethiopia: A Comparative Cross-Sectional Study

Eshetu¹,

Worede²,

Fentie³

et al. 2023

DMSO

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Introduction: Electrolyte imbalance refers to altered electrolyte levels that predominantly affect diabetic patients due to hyperglycemia which rise plasma osmolality and impaired renal function, contributing to a change in electrolyte level. Therefore, this study aimed to assess the prevalence of electrolyte imbalance and its associated factors among diabetic patients and healthy control groups attending the University of Gondar Comprehensive Specialized Hospital. Patients and Methods: A comparative cross-sectional study was conducted on 130 diabetic patients and 130 diabetes-free controls. Sociodemographic, behavioral and clinical data were collected using a structured questionnaire. After measuring anthropometric parameters, 5mL of the blood sample was collected. Electrolytes were measured based on ion-selective electrode methods. Fasting blood glucose, and creatinine were measured by spectrophotometric enzyme hexokinase, and Jaffe reaction methods, respectively. The data was entered into Epi-data version 4.6 and analyzed using STATA version 14. Mann-Whitney U-tests and independent t-tests were used for comparison. Multiple logistic regression analysis was done to determine the factors associated with electrolyte imbalances. P-value <0.05 was considered statistically significant. Result: The overall prevalence of electrolyte imbalance among diabetic patients and controls were 83.07% and 52.31%, respectively. The mean of Na + and the median level of Mg 2+ and Ca 2+ were significantly decreased. However, the mean level of Cl − was significantly increased in diabetic patients as compared to control groups. In multivariable logistic regression: alcohol consumption AOR = 3.34 [1.02-10.9], no formal education ], hyperglycemia AOR = 6.32 [2.04-19.5], and urbanization ] showed significant association with electrolyte imbalance. Conclusion: Diabetic patients have more likely to develop electrolyte imbalance than control groups. Diabetic participants showed significantly reduced Na + , Mg 2+ , and Ca 2+ levels and significantly increasing CI − levels when compared to control groups. Hyperglycemia, alcohol drinking habits, urbanization, and no-formal education were statistically significantly associated with electrolyte imbalance.

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Section: Discussioncontrasting

confidence: 89%

Assessment of Electrolyte Imbalance and Associated Factors Among Adult Diabetic Patients Attending the University of Gondar Comprehensive Specialized Hospital, Ethiopia: A Comparative Cross-Sectional Study

Eshetu¹,

Worede²,

Fentie³

et al. 2023

DMSO

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“…Similarly, a female preponderance was also seen in other studies, while others showed no sexual preference for hyponatremia. [17][18][19] Grikinienė et al demonstrated a clear-cut predilection for the feminine gender in cases with hyponatremia. Moreover, females are most vulnerable to brain damage from hyponatremia and are more liable to have brain demyelination (ODS), as a result of excessive therapeutic correction of hyponatremia.…”

Section: Discussionmentioning

confidence: 99%

Hyponatremia in hospitalized patients with chronic kidney disease; aetiology, treatment, and outcome, in a tertiary care hospital, Dubai, UAE

et al. 2021

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Background: Hyponatremia is common among hospitalized patients. Unfortunately, articles describing the management of profound hyponatremia (serum sodium <125 mEq/l) in the background of kidney disease are scarce. This review focuses on the incidence, prevalence, patient characteristics, and clinical features among hospitalized chronic kidney disease (CKD) patients with particular attention to CKD stage 3 to 5.Methods: 71 adult patients with CKD stage 3 to 5 and had presented with profound hyponatremia (serum sodium <125 mEq/l) were included. Patient demographic data, laboratory parameters and treatment received were recorded. The primary endpoint was the development of central nervous syste (CNS) manifestations, while the secondary outcomes included early mortality (death within 30 days).Results: 97 episodes of hyponatremia were recorded in 71 patients. 35 patients (49%) were UAE national and 53.5% patients were females. 52% were in CKD stage-5 refusing dialysis. Diabetic nephropathy was the underlying cause in 66%. The initial Sodium level upon admission ranged from 107-125 mEq/l, with a mean±standard deviation (SD) value of 117.7±4.54 mEq/l. The correction of hyponatremia had ranged between 24 hours in 60% of the patients to 96 hours. Diuretics were used in conjunction with the saline in 85%. Hospital stay ranged between 2-58 days (average 11.7 days). No CNS symptoms were recorded in any of the treated patients. Three patients had died (within 30 days) of sepsis of different sources.Conclusions: Management of hyponatremia in CKD patients remains challenging and should be directed to the underlying cause. Yet, complex patients with advanced CKD particularly in concurrence with heart failure might represent a medical dilemma. Administering hypertonic saline in different mixed concentrations depending on the volume status of the patients appear to be safe, efficient, and suitable for high-risk CKD patients while monitoring Sodium level carefully.

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“…In addition to the impairment of their main transport system, Sahid SM and Mahboob T 2008 [3] proposed progressive patterns in electrolyte abnormalities in diabetes mellitus leading to end stage renal disease. Diabetes can lower serum Na+ levels by creating a dilution effect that shifts water from intracellular to extracellular compartments because glucose is osmotically active [4] . In contrast to patients without anemia, people with anemia had lower salt and potassium levels, according to Mansoor F et al 2021 [5] .…”

Section: Introductionmentioning

confidence: 99%

Evaluation of haemoglobin and serum electrolyte in the case of glycosuria

Kathiriya,

Patel,

Patel

et al. 2023

Int. J. Appl. Res.

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Background: Electrolyte imbalance range in severity of its kind. It primarily affect diabetics because of osmotic fluid changes brought on by hyperglycemia. Numerous writers have discussed it in relation to diabetic and anemic patients, but there hasn't been much discussion of glycosuria, a disease brought on by the proximal tubules of the glomerulus failing to absorb enough sugar or glucose. Aim: To determine the relationship between electrolyte (Sodium & Potassium), haemoglobin, and urine glucose/glycosuria concentration. Materials and Method: A total of 170 patients (90 men and 80 women) blood & urine samples were evaluated in the study, which was carried out at Saraswati Multispeciality Hospital & Trauma Centre, Bopal, Ahmedabad between January 2023 and March 2023. The samples were examined using conventional automatic instruments. Result: The concentration of electrolytes (Sodium and Potassium) had shown an increase with the increase in age from 0 to 30 in the age group of 0 to 5 and 5 to 30 in case of male & female both respectively but the pattern was observed variable after the age of 30 in both the cases (male & female) in the age group of 30 to 50 and above 50. Our observation shows that, in the case of glycosuria, there were no obvious electrolyte imbalances (sodium and potassium) at normal haemoglobin level. Conclusion:We saw an age-dependent pattern of electrolyte imbalance, but none of them fell within the reference range of hyponatremia, hypernatremia, hypokalemia, and hyperkalemia.

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Factors Influencing Hyponatremia in Hospitalized Diabetic Patients- A Cross Sectional Study

Cited by 3 publications

References 19 publications

Assessment of Electrolyte Imbalance and Associated Factors Among Adult Diabetic Patients Attending the University of Gondar Comprehensive Specialized Hospital, Ethiopia: A Comparative Cross-Sectional Study

Assessment of Electrolyte Imbalance and Associated Factors Among Adult Diabetic Patients Attending the University of Gondar Comprehensive Specialized Hospital, Ethiopia: A Comparative Cross-Sectional Study

Hyponatremia in hospitalized patients with chronic kidney disease; aetiology, treatment, and outcome, in a tertiary care hospital, Dubai, UAE

Evaluation of haemoglobin and serum electrolyte in the case of glycosuria

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