HIV/AIDS-related hyponatremia: an old but still serious problem

Shu, Zhanjun; Tian, Zimeng; Chen, Jing‐Lin; Ma, Jianping; Abudureyimu, Aihemaiti; Qian, Qianqian; Li, Zhuo

doi:10.1080/0886022x.2017.1419975

Cited by 17 publications

(14 citation statements)

References 50 publications

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“…Sodium and calcium regulate the water balance, blood pressure, blood volume, heart rhythm and most importantly the brain and nerve function [ 84 , 85 , 92 ]. Changes in the sodium concentration are known to create an osmotic gradient between the extra- and intracellular fluid in cells [ 94 ] suggesting that a proper balance is essential. Magnesium is involved in muscle contractions and protein processing [ 84 ], ALP in detecting liver health [ 1 , 95 , 96 ] and folate for cell growth and metabolism [ 97 , 98 ].…”

Section: Discussionmentioning

confidence: 99%

An Evaluation to Determine the Strongest CD4 Count Covariates during HIV Disease Progression in Women in South Africa

et al. 2019

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Introduction Past endeavours to deal with the obstacle of expensive Cluster of Difference 4 (CD4 + ) count diagnostics in resource-limited settings have left a long trail of suggested continuous CD4 + count clinical covariates that turned out to be a potentially important integral part of the human immunodeficiency virus (HIV) treatment process during disease progression. However, an evaluation to determine the strongest candidates among these CD4 + count covariates has not been well documented. Methods The Centre for the AIDS Programme of Research in South Africa (CAPRISA) initially enrolled HIV-negative (phase 1) patients into different study cohorts. The patients who seroconverted (237) during follow-up care were enrolled again into a post-HIV infection cohort where they were further followed up with weekly to fortnightly visits up to 3 months (phase 2: acute infection), monthly visits from 3–12 months (phase 3: early infection) and quarterly visits thereafter (phase 4: established infection) until antiretroviral therapy (ART) initiation (phase 5). The CD4 + count and 46 covariates were repeatedly measured at each phase of the HIV disease progression. A multilevel partial least squares approach was applied as a variable reduction technique to determine the strongest CD4 + count covariates. Results Only 18 of the 46 investigated clinical attributes were the strongest CD4 + count covariates and the top 8 were positively and independently associated with the CD4 + count. Besides the confirmatory lymphocytes , these were basophils , albumin , haematocrit , alkaline phosphatase (ALP) , mean corpuscular volume (MCV) , platelets , potassium and monocytes . Overall, electrolytes, proteins and red blood cells were the dominant categories for the strongest covariates. Conclusion Only a few of the many previously suggested continuous CD4 + count clinical covariates showed the potential to become an important integral part of the treatment process. Prolonging the pre-treatment period of the HIV disease progression by effectively incorporating and managing the covariates for long-term influence on the CD4 + cell response has the potential to delay challenges associated with ART side effects. Electronic supplementary material The online version of this article (10.1007/s40121-019-0235-4) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

An Evaluation to Determine the Strongest CD4 Count Covariates during HIV Disease Progression in Women in South Africa

et al. 2019

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“…Hyponatremia is a very common electrolyte abnormality among patients with AIDS [ 15 ]. According to literature, hyponatremia may occur in 20–80% of hospitalized patients with HIV disease or AIDS [ 15 ]. A common comorbidity in HIV-infected patients are pulmonary or CNS infections, which may result in SIADH.…”

Section: Hyponatremia Due To Infectionsmentioning

confidence: 99%

“…The most common causes of SIADH are malignancies, pulmonary disorders such as community-acquired pneumonia, central nervous system disorders, and drugs [ 6 , 13 , 14 ]. In HIV/AIDS patients, opportunistic infections of the pulmonary tract or CNS can also induce the release of excessive ADH [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

Hyponatremia in Infectious Diseases—A Literature Review

Królicka

Kruczkowska

Krajewska

et al. 2020

IJERPH

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Hyponatremia is one of the most common water–electrolyte imbalances in the human organism. A serum sodium concentration threshold of less than 135 mmol/L is diagnostic for hyponatremia. The disorder is usually secondary to various diseases, including infections. Our review aims to summarize the diagnostic value and impact of hyponatremia on the prognosis, length of the hospitalization, and mortality among patients with active infection. The scientific literature regarding hyponatremia was reviewed using PubMed, ClinicalKey, and Web of Science databases. Studies published between 2011 and 2020 were screened and eligible studies were selected according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement and specific inclusion criteria. The most common infections that were associated with hyponatremia were viral and bacterial infections, including COVID-19 (coronavirus disease 2019). The etiology varied according to the infection site, setting and patient cohort it concerned. In several studies, hyponatremia was associated with prolonged hospitalization, worse outcomes, and higher mortality rates. Hyponatremia can also play a diagnostic role in differentiating pathogens that cause a certain infection type, as it was observed in community-acquired pneumonia. Although many mechanisms leading to hyponatremia have already been described, it is impossible with any certainty to ascribe the etiology of hyponatremia to any of them.

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“…SIADH is an exclusion diagnosis that requires an extensive work up to rule out other etiologies including adrenal insufficiency, thyroid disease, and volume depletion (Shu et al, 2018). ADH is produced on the paraventricular thalamic nucleus and thus classically this syndrome is observed after neurological insults that cause an excess in ADH.…”

Section: Discussionmentioning

confidence: 99%