Background: Hyponatremia overcorrection can result in irreversible neurologic impairment such as osmotic demyelination syndrome. Few prospective studies have identified patients undergoing hypertonic saline treatment with a high risk of hyponatremia overcorrection. Methods: We conducted a post hoc analysis of a multicenter, prospective randomized controlled study, the SALSA trial, in 178 patients aged above 18 years with symptomatic hyponatremia (mean age, 73.1 years; mean serum sodium level, 118.2 mEq/L). Overcorrection was defined as an increase in serum sodium levels by >12 or 18 mEq/L within 24 or 48 hours, respectively. Results: Among the 178 patients, 37 experienced hyponatremia overcorrection (20.8%), which was independently associated with initial serum sodium level (≤110, 110-115, 115-120, and 120-125 mEq/L with 7, 4, 2, and 0 points, respectively), chronic alcoholism (7 points), severe symptoms of hyponatremia (3 points), and initial potassium level (<3.0 mEq/L, 3 points). The NASK (hypoNatremia, Alcoholism, Severe symptoms, and hypoKalemia) score was derived from four risk factors for hyponatremia overcorrection and was significantly associated with overcorrection (odds ratio, 1.41; 95% confidence interval, 1.24-1.61; p < 0.01) with good discrimination (area under the receiver-operating characteristic [AUROC] curve, 0.76; 95% CI, 0.66-0.85; p < 0.01). The AUROC curve of the NASK score was statistically better compared with those of each risk factor. Conclusion: In treating patients with symptomatic hyponatremia, individuals with high hyponatremia overcorrection risks were predictable using a novel risk score summarizing baseline information.
Coronavirus disease 2019 (COVID-19) vaccines have shown excellent safety profiles. The most common short-term side effects are injection site reactions, fever, fatigue, and headache, while severe adverse reactions have rarely been reported [1]. However, since mass-scale vaccination began, several immune-mediated reactions (including myocarditis and de novo or relapsed glomerulonephritis [GN]) have been reported [1]. COVID-19 vaccines have also been reported to induce T-cell activation [2]. In this regard, the occurrence of kidney disease following administration of a COVID-19 vaccine can be related to the T-cell-mediated immune response it generates to viral messenger RNA (mRNA), which can trigger podocyte injury [2]. Herein, we report a case of focal segmental glomerulosclerosis (FSGS) with segmental lobular collapse and podocyte proliferation following vaccination with the first dose of the Pfizer-BioN-Tech COVID-19 vaccine that mimicked the cellular lesions of FSGS.A previously healthy 29-year-old man visited our hospital with complaints of edema and decreased urine output that had occurred 7 days previously. He had received a COVID-19 vaccine 2 weeks prior (Fig. 1). He had also undergone a health checkup 3 months before the visit, including urinalysis and renal function testing, which showed no
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.