Prevalence of Hyponatremia and Association with Mortality: Results from NHANES

Mohan, Sumit; Gu, Sue; Parikh, Amay; Radhakrishnan, Jai

doi:10.1016/j.amjmed.2013.07.021

Cited by 218 publications

(206 citation statements)

References 41 publications

Supporting

Mentioning

187

Contrasting

Unclassified

Order By: Relevance

“…Corrected Na + levels were computed for patients where concomitant serum glucose was >200 mg/dl, using the formula [12,13]: corrected Na + = measured Na + + 1.6 (serum glucose - 100)/100.…”

Section: Methodsmentioning

confidence: 99%

Serum Sodium Levels and Patient Outcomes in an Ambulatory Clinic-Based Chronic Kidney Disease Cohort

et al. 2015

View full text Add to dashboard Cite

Background: Chronic kidney disease (CKD) patients are prone to both hypo- and hypernatremia. Little has been published on the epidemiology of hypo- and hypernatremia in ambulatory patients with non-dialysis CKD. Methods: Data collected in two contemporaneous CKD cohort studies, the Renal Research Institute (RRI)-CKD study (n = 834) and the Study of Treatment of Renal Insufficiency: Data and Evaluation (STRIDE) (n = 1,348) were combined and analyzed to study the association between serum sodium (Na⁺) and clinical outcomes. Results: Baseline estimated glomerular filtration rate (eGFR) and Na⁺ were 26 ± 11 ml/min/1.73 m² and 140.2 ± 3.4 mEq/l, respectively. The prevalence of Na⁺ ≤135 mEq/l and ≥144 mEq/l was 6 and 16%, respectively. Higher baseline Na⁺ was significantly associated with male sex, older age, systolic blood pressure, BMI, serum albumin, presence of heart failure, and lower eGFR. The risk of end-stage renal disease (ESRD) was marginally significantly higher among patients with Na⁺ ≤135 mEq/l, compared with 140< Na⁺ <144 mEq/l (referent), in time-dependent models (adjusted hazard ratio, HR = 1.52, p = 0.06). Mortality risk was significantly greater at 135< Na⁺ ≤140 mEq/l (adjusted HR = 1.68, p = 0.02) and Na⁺ ≥144 mEq/l (adjusted HR = 2.01, p = 0.01). Conclusion: CKD patients with Na⁺ ≤135 mEq/l were at a higher risk for progression to ESRD, whereas both lower and higher Na⁺ levels were associated with a higher risk of mortality. While caring for CKD patients, greater attention to serum sodium levels by clinicians is warranted and could potentially help improve patient outcomes.

show abstract

“…Corrected Na + levels were computed for patients where concomitant serum glucose was >200 mg/dl, using the formula [12,13]: corrected Na + = measured Na + + 1.6 (serum glucose - 100)/100.…”

Section: Methodsmentioning

confidence: 99%

Serum Sodium Levels and Patient Outcomes in an Ambulatory Clinic-Based Chronic Kidney Disease Cohort

et al. 2015

View full text Add to dashboard Cite

show abstract

“…In a cross-sectional study, Mohan et al (13) measured PNa in 14,697 adults who participated in the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2004. At an estimated prevalence of 1.72%, hyponatremia was associated with an HR of death of 3.61 (95% CI, 2.31 to 5.63; P,0.001).…”

Section: Significance Of Mild Chronic Hyponatremia Mild Chronic Hyponmentioning

confidence: 99%

Mild Chronic Hyponatremia in the Ambulatory Setting

Rondon‐Berrios

Berl

2015

Clinical Journal of the American Society of Nephrology

View full text Add to dashboard Cite

Mild chronic hyponatremia, as defined by a persistent (>72 hours) plasma sodium concentration between 125 and 135 mEq/L without apparent symptoms, is common in ambulatory patients and generally perceived as being inconsequential. The association between increased mortality and hyponatremia in hospitalized patients in various settings and etiologies is widely recognized. This review analyzes the significance of mild chronic hyponatremia in ambulatory subjects and its effects on mortality and morbidity. It addresses whether this disorder should even be treated and if so, which patients are likely to benefit from treatment. The available approaches to correct hyponatremia in such patients in the context of recently published panel-generated recommendations and guidelines are described.

show abstract

“…32 Hyponatremia is the most common electrolyte disorder in hospitalized patients. 33 The presence of hyponatremia at admission or during index hospitalization is associated All models were adjusted for sex, age, systolic blood pressure, diabetes mellitus, atrial fibrillation, heart failure history, peripheral artery disease, hemoglobin, estimated glomerular filtration rate, blood urea nitrogen, left ventricular ejection fraction, Killip class, diuretic use, and body mass index. For NRI and IDI, the time point of event definition was the median follow-up for each end point.…”

Section: Chloride Pathophysiology and Interplay With Sodiummentioning

confidence: 99%

Serum Chloride and Sodium Interplay in Patients With Acute Myocardial Infarction and Heart Failure With Reduced Ejection Fraction

Ferreira

Girerd

Duarte

et al. 2017

Circ: Heart Failure

View full text Add to dashboard Cite

Background— Serum chloride levels were recently found to be independently associated with mortality in heart failure (HF). Methods and Results— We investigated the relationship between serum chloride and clinical outcomes in 7195 subjects with acute myocardial infarction complicated by reduced left ventricular function and HF. The studied outcomes were all-cause mortality, cardiovascular mortality, and hospitalization for HF. Both chloride and sodium had a nonlinear association with the studied outcomes ( P <0.05 for linearity). Patients in the lowest chloride tertile (chloride ≤100) were older, had more comorbidities, and had lower sodium levels ( P <0.05 for all). Serum chloride showed a significant interaction with sodium with regard to all studied outcomes ( P for interaction <0.05 for all). The lowest chloride tertile (≤100 mmol/L) was associated with increased mortality rates in the context of lower sodium (≤138 mmol/L; adjusted hazard ratio [95% confidence interval] for all-cause mortality=1.42 (1.14–1.77); P =0.002), whereas in the context of higher sodium levels (>141 mmol/L), the association with mortality was lost. Spline-transformed chloride and its interaction with sodium did not add significant prognostic information on top of other well-established prognostic variables ( P >0.05 for all outcomes). Conclusions— In post–myocardial infarction with systolic dysfunction and HF, low serum chloride was associated with mortality (but not hospitalization for HF) in the setting of lower sodium. Overall, chloride and its interaction with sodium did not add clinically relevant prognostic information on top of other well-established prognostic variables. Taken together, these data support an integrated and critical consideration of chloride and sodium interplay.

show abstract

Prevalence of Hyponatremia and Association with Mortality: Results from NHANES

Cited by 218 publications

References 41 publications

Serum Sodium Levels and Patient Outcomes in an Ambulatory Clinic-Based Chronic Kidney Disease Cohort

Serum Sodium Levels and Patient Outcomes in an Ambulatory Clinic-Based Chronic Kidney Disease Cohort

Mild Chronic Hyponatremia in the Ambulatory Setting

Serum Chloride and Sodium Interplay in Patients With Acute Myocardial Infarction and Heart Failure With Reduced Ejection Fraction

Contact Info

Product

Resources

About