Mild Hyponatremia Carries a Poor Prognosis in Community Subjects

Sajadieh, Ahmad; Binici, Zeynep; Mouridsen, Mette Rauhe; Nielsen, Olav Wendelboe; Hansen, Jørgen Fischer; Haugaard, Steen B.

doi:10.1016/j.amjmed.2008.11.033

Cited by 152 publications

(120 citation statements)

References 20 publications

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“…Further prospective studies are warranted to evaluate the nature of some of these morbidities, including defining whether they are an association or a direct result of hyponatraemia. In addition, hyponatraemia (plasma sodium 125-135 mmol/l) has been associated with increased mortality in almost every population studied, including community patients (19), hospitalised patients (20), patients with pneumonia (21) and patients in intensive care (22). For these reasons, even without data from intervention studies, it is prudent to try to maintain plasma sodium concentrations in the eunatraemic rather than the hyponatraemic range in CDI.…”

Section: Discussionmentioning

confidence: 99%

Abnormal plasma sodium concentrations in patients treated with desmopressin for cranial diabetes insipidus: results of a long-term retrospective study

Behan

Sherlock

Moyles

et al. 2015

European Journal of Endocrinology

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Context and objective: Patients with cranial diabetes insipidus (CDI) are at risk of developing both hypernatraemia and hyponatraemia, due to the condition itself or secondary to treatment with vasopressin-analogues or during administration of i.v. fluids. We aimed to assess the frequency and impact of dysnatraemias in the inpatient (INPT) and outpatient (OPT) setting in desmopressin-treated CDI, comparing those with normal thirst with those with abnormal thirst. Design: The study included 192 patients with cranial diabetes, who were identified from the Beaumont Pituitary Database, a tertiary referral centre. Retrospective case note audit was performed and the clinical and biochemical information of 147 patients with CDI were available for analysis. Results: A total of 4142 plasma sodium measurements for 137 patients with normal thirst, and 385 plasma sodium measurements for ten patients with abnormal thirst were analysed. In those with normal thirst, the most common OPT abnormality was mild hyponatraemia (pNa C 131-134 mmol/l) in 27%, while 14.6% had more significant hyponatraemia (pNa C %130 mmol/l). Of those patients with normal thirst, 5.8% were admitted due to complications directly related to hyponatraemia. Compared with patients with normal thirst, those with abnormal thirst were more likely to develop significant OPT hypernatraemia (20% vs 1.4%, PZ0.02) and significant INPT hyponatraemia (50% vs 11.1%, P 0.02). Conclusion: OPT management of CDI is complicated by a significant incidence of hyponatraemia. In contrast, OPT hypernatraemia is almost exclusively a complication seen in adipsic CDI, who also had more frequent INPT hyponatraemia. CDI associated with thirst disorder requires increased physician attention and patient awareness of potential complications.

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Section: Discussionmentioning

confidence: 99%

Abnormal plasma sodium concentrations in patients treated with desmopressin for cranial diabetes insipidus: results of a long-term retrospective study

Behan

Sherlock

Moyles

et al. 2015

European Journal of Endocrinology

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“…The relationship between mortality and plasma sodium concentration was most pronounced in patients with cardiac disease and metastatic cancer, which does raise the possibility that the excess mortality was associated with the conditions responsible for hyponatraemia, but interestingly, resolution of hyponatraemia during hospitalisation reduced the associated mortality, suggesting that the electrolyte disturbance was in itself a contributor to excess mortality. The results of this study were complemented by those of a populationbased study from Denmark, which showed that mild hyponatraemia (!137 mmol/l) also conferred increased hazard ratio for adverse outcome, even in the group with plasma sodium concentrations between 134 and 137 mmol/l (23). The overwhelming message from the published data is that even mild hyponatraemia increases mortality.…”

Section: Mortality and Hyponatraemiamentioning

confidence: 67%

Hyponatraemia: new associations and new treatments

Thompson

2010

European Journal of Endocrinology

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“…The fatality rate for hyponatremic patients was 60-fold that for patients without documented hyponatremia (Anderson et al, 1985). Hyponatremia is an independent predictor of death and myocardial infarction in middle-aged and elderly community subjects, respectively (Sajadieh et al, 2009). Hyponatremic patients with congestive heart failure are associated with a 75% increase in 60-to 90-day mortality, compared with normonatremic patients (Gheorghiade et al, 2007).…”

Section: Hyponatremia In Hospitalized Patientsmentioning

confidence: 99%

Hyponatremia and Hypokalemia in Peritoneal Dialysis Patients

Kim¹

2011

Progress in Peritoneal Dialysis

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Mild Hyponatremia Carries a Poor Prognosis in Community Subjects

Cited by 152 publications

References 20 publications

Abnormal plasma sodium concentrations in patients treated with desmopressin for cranial diabetes insipidus: results of a long-term retrospective study

Abnormal plasma sodium concentrations in patients treated with desmopressin for cranial diabetes insipidus: results of a long-term retrospective study

Hyponatraemia: new associations and new treatments

Hyponatremia and Hypokalemia in Peritoneal Dialysis Patients

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