Pmh38 Identification of Risk Factors Associated With Hyponatremia in Psychiatric Patients: A Case Control Study

Powle, Himani; Shet, Arun; Mendonca, A.A.; Kunhikatta, Vijayanarayana; Thunga, Girish

doi:10.1016/j.jval.2019.09.1512

Cited by 1 publication

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“…In the post hoc analysis, the OR for combined use of both statins and ezetimibe was lower than the OR for use of either compound alone, consistent with an additive effect. This observation does not provide obvious clues to the underlying mechanism, as it is consistent with both direct effects from the drugs, and indirect effects from altered lipid-profiles, but it does support an inverse association between statins and hyponatremia, as do findings from smaller studies similar to ours [21][22][23]. Still, pending additional data in support of a protective effect from lipid-lowering drugs with regard to hyponatremia, the most prudent conclusion is perhaps that lipid lowering agents, statins and ezetimibe in particular, are unlikely to cause or contribute to severe hyponatremia.…”

Section: Discussionsupporting

confidence: 41%

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Association between lipid-lowering agents and severe hyponatremia: a population-based case–control study

Skov

Falhammar

Calissendorff

et al. 2020

Eur J Clin Pharmacol

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Purpose Drug-induced hyponatremia is common, with medications from many drug-classes implicated. Lipid-lowering agents are among the most prescribed drugs. Limited evidence suggests an inverse association between statins and hyponatremia, while data on other lipid-lowering agents is absent. The objective of this investigation was to study the association between lipid-lowering drugs and hospitalization due to hyponatremia. Methods This was a register-based case–control study of the general Swedish population. Those hospitalized with a main diagnosis of hyponatremia (n = 11,213) were compared with matched controls (n = 44,801). Multivariable logistic regression adjusting for co-medication, diseases, previous hospitalizations, and socioeconomic factors was used to explore the association between severe hyponatremia and the use of lipid-lowering drugs. Results Unadjusted ORs (95% CI) for hospitalization due to hyponatremia were 1.28 (1.22–1.35) for statins, 1.09 (0.79–1.47) for ezetimibe, 1.38 (0.88–2.12) for fibrates, and 2.12 (1.31–3.35) for resins. After adjustment for confounding factors the adjusted odds ratios (95% CI) compared with controls were 0.69 (0.64–0.74) for statins, 0.60 (0.41–0.86) for ezetimibe, 0.87 (0.51–1.42) for fibrates, and 1.21 (0.69–2.06) for resins. Conclusions Use of statins and ezetimibe was inversely correlated with severe hyponatremia. Consequently, these drugs are unlikely culprits in patients with hyponatremia, and they appear safe to initiate in hyponatremic patients. A potential protective effect warrants further studies on how statins and other lipid-lowering drugs are linked to dysnatremias.

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Section: Discussionsupporting

confidence: 41%

“…To the best of our knowledge, no studies reporting on increased risk of hyponatremia in patients treated with statins have been published. To the contrary, the limited data available suggests a modest inverse association between statins and hyponatremia [21][22][23]. while data on other lipid-lowering agents is absent.…”

Section: Introductionmentioning

confidence: 99%