Low serum sodium concentration is a prognostic factor related to current blood glucose level in stable hemodialysis patients: an observational study

Nagai, Kojiro; Ueda, Sayo; Tsuchida, Kenji; Doi, Toshio; Murata, Jun

doi:10.1186/s41100-017-0138-3

Cited by 7 publications

(6 citation statements)

References 28 publications

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“…The reduced serum level of sodium in the SCD patients may be due to at least, in part, a possible loss of some body fluids and electrolytes, as well as inflammation and the underlying chronic condition. 18 Although serum sodium levels were significantly higher in the control group, no significant difference was observed between HbSS patients and those with the HbSC genotype. The reduced serum sodium levels in the HbSS patients, compared with the HbSC patients (although not significantly different), partially agree with Aluoch.…”

Section: Discussionmentioning

confidence: 82%

Serum Potassium, Sodium, and Chloride Levels in Sickle Cell Disease Patients and Healthy Controls: A Case-Control Study at Korle-Bu Teaching Hospital, Accra

et al. 2019

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The activity of Na+-K+ ATPase is altered in sickle cell disease (SCD), which affects serum electrolyte levels. This alteration is associated with several complications in sickle cell patients. This study evaluated the serum levels of sodium, potassium, and chloride in patients with SCD. The study was a case-control cross-sectional study involving 120 SCD patients in the steady state and 48 ‘healthy’ controls. The SCD patients were made up of 69 HbSS patients and 41 HbSC patients. Serum electrolyte levels (Na+, K+, and Cl−) were measured using a Flame Atomic Absorption Spectrometer (Variant 240FS; Varian Australia Pty Ltd). Serum sodium levels were significantly lower in the sickle cell patients, compared with their ‘healthy’ counterparts ( P = .0001). Although the study found significantly higher serum levels of potassium in the SCD patients ( P = .0001), there was no significant difference in serum chloride levels between patients with SCD and the controls ( P = .098). Serum sodium and chloride levels were not significantly different in both HbSS and HbSC patients ( P = .197 and P = .553, respectively). The level of serum potassium in the HbSS patients was, however, significantly higher compared with those with the HbSC genotype ( P = .0001). There is higher efflux of K+ from the intracellular into the extracellular space in HbSS patients, which may lead to red cell membrane dysfunction and associated complications.

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Section: Discussionmentioning

confidence: 82%

Serum Potassium, Sodium, and Chloride Levels in Sickle Cell Disease Patients and Healthy Controls: A Case-Control Study at Korle-Bu Teaching Hospital, Accra

et al. 2019

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“…Among serum electrolytes assessed, hyponatremia or low serum sodium concentration was the most prevalent abnormality in diabetic patients. 2,13,16,21,24,[26][27][28][29][30][31] The low serum concentration of sodium ion in diabetic patients may be due to osmotic diuresis induced hypovolemia. This means glucose is a substance with high osmotic activity, so its high concentration or hyperglycemia leads to increased serum osmolality that causes movement of water out of the cells and causes hypo-natremia by dilution.…”

Section: Discussionmentioning

confidence: 99%

<p>Assessment of Selected Serum Electrolyte and Associated Risk Factors in Diabetic Patients</p>

Woyesa¹,

Gebisa²,

Anshebo³

2020

DMSO

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The objective of this study was to assess selected serum electrolytes imbalance and associated factors in diabetic patients attending their follow up appointments in Jimma University Medical Center (JUMC) from February 1 to April 1, 2019. Patients and methods: A cross sectional study design was used to assess the selected serum electrolytes in diabetic patients attending their follow up appointments at Jimma University Medical Center (JUMC) chronic illness clinic. A convenience sampling technique was used to include 279 diabetic patients in the study and an interviewer based questionnaire was used to include all necessary data from each diabetic patient. Five milliliters of blood were collected from each subject and processed and analyzed for blood glucose and serum electrolyte determination by ABX Pentra400 and Humalyte plus 5 ion-selective electrode (ISE) system clinical chemistry analyzers. Pearson's correlation coefficient model and multivariate logistic regression were used respectively to assess the correlation and significant association between abnormal serum electrolytes and independent variables. Results: A high prevalence of one or more serum electrolyte abnormalities was determined in diabetic patients. The overall prevalence was 42.0% (n=116/276) in which hyponatremia was the highest followed by hypochloremia and hypercalcemia, 40.6%, 14.9% and 10.9% respectively. Age, type of medication, and high body mass index (BMI) had strong positive correlations with abnormal serum concentration levels of sodium (r=0.611, P=0.731), potassium (r=0.752, P=0.812) and chloride (r=0.645, P=0.459). Being employed (AOR: 3.933, 95% C.I: 1.057-14.637, P value: 0.041), treated with mixed medications (AOR: 2.9, 95% C.I: 1.292-6.441, P value: 0.010) and being unable to control blood glucose level or being hyperglycemic (AOR: 3.2, 95% C.I: 2.179-5.721, P value: 0.000) were statistically identified as risk factors for serum electrolyte abnormalities in diabetic patients. Conclusion:The serum electrolyte concentration level was highly abnormal in diabetic patients. The prevalence of abnormal concentration was more common in diabetic patients with advanced age, and some variables had strong positive correlation with abnormal serum electrolyte level in diabetic patients.

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“…RRF has been identified as a key determinant of sNa in HD ( 16 , 27 ) and PD populations ( 17 , 28 , 29 ), suggesting that RRF even in the advanced stage can contribute to sodium handling and prevent hyponatremia by excreting relatively more water than sodium. The observed inverse association between sNa and hyperglycemia in dialysis patients due to water shifts from the intracellular to the extracellular compartment is well-documented ( 15 , 18 , 27 , 29 , 34 ). Similarly, the reported association of icodextrin with lower sNa levels ( 28 , 35 , 36 ) is likely related to a dilutional effect due to an osmotic gradient caused by blood levels of icodextrin and metabolites.…”

Section: Discussionmentioning

confidence: 91%

The Association Between Handgrip Strength and Predialysis Serum Sodium Level in Patients With Chronic Kidney Disease Stage 5D

et al. 2021

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Purpose: Handgrip strength (HGS) is a useful tool for the systematic assessment of muscle function related to nutritional status. Reduced HGS has been associated with adverse clinical outcomes in chronic kidney disease (CKD) stage 5D patients. In the same patients, predialysis low serum sodium (sNa) has been associated with malnutrition and mortality. Here, we investigated the role of predialysis sNa on muscle function in CKD-5D patients.Methods: We evaluated 45 patients on hemodialysis (HD) and 28 patients on peritoneal dialysis (PD) with HGS measurement, bioimpedance analysis, anthropometric measures, and malnutrition inflammation score (MIS). According to established diagnostic criteria, reduced HGS was defined as strength below 30 and 20 Kg in men and women, respectively. Predialysis sNa values were defined as the mean of all predialysis measurements during the preceding 6 months. Data analysis was performed separately for each of the HD and PD groups.Results: The proportions of reduced HGS did not differ between the HD (66%) and PD (54%) groups, respectively. Patients in the HD group as compared to those in the PD group had higher serum albumin and potassium and mid-arm muscle circumference and lower residual renal function (RRF) and residual urine volume. Multivariate logistic analysis, after controlling for muscle mass, nutritional biomarkers, MIS, fluid overload and RRF, showed that for every 1 mmol/l increase of sNa the odds of reduced HGS was decreased by 60% (OR = 0.40, 95% CI: 0.16–0.99) and 42% (OR = 0.58, 95% CI: 0.36–0.93) in HD and PD patients, respectively. However, stratified analysis indicated that lower sNa levels predicted reduced HGS in individuals with a background of malnutrition, inflammation, overhydration and less preserved RRF, representing unfavorable conditions strongly related to muscle wasting in the dialysis setting.Conclusions: Predialysis sNa is a strong and independent determinant of HGS, a reliable nutritional marker in CKD-5D stage patients. However, according to our findings, lower sNa levels appear to be a marker of underlying unfavorable conditions that are heavily associated with reduced HGS, rather than a causal determinant of reduced HGS. Whether optimizing sNa levels improves patient muscle performance requires further investigations.

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Low serum sodium concentration is a prognostic factor related to current blood glucose level in stable hemodialysis patients: an observational study

Cited by 7 publications

References 28 publications

Serum Potassium, Sodium, and Chloride Levels in Sickle Cell Disease Patients and Healthy Controls: A Case-Control Study at Korle-Bu Teaching Hospital, Accra

Serum Potassium, Sodium, and Chloride Levels in Sickle Cell Disease Patients and Healthy Controls: A Case-Control Study at Korle-Bu Teaching Hospital, Accra

<p>Assessment of Selected Serum Electrolyte and Associated Risk Factors in Diabetic Patients</p>

The Association Between Handgrip Strength and Predialysis Serum Sodium Level in Patients With Chronic Kidney Disease Stage 5D

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