BackgroundHyponatremia is one of the most commonly encountered electrolyte disorders in emergency department (ED). Seasonal fluctuations of the prevalence of hyponatremia has been reported. We investigated the impact of age on the seasonal prevalence of hyponatremia in the emergency department in Japan.MethodsTotal of 8377 patients presented to the ED between January 2015 and December 2016 were reviewed. The adult group aged between 18 and 64 years old consisted of 3656 patients and the elderly group aged over 65 years consisted of 4721 patients. Information collected included age, sex, serum sodium, and serum creatinine. Hyponatremia was defined as a serum sodium leve1 < 135 mEq/L and severe hyponatremia was defined as a serum sodium level < 125 mEq/L.ResultsPrevalence of hyponatremia was significantly higher in the elderly group than in the adult group (17.0% vs. 5.7%, p < 0.001). Similarly, the prevalence of severe hyponatremia was significantly higher in the elderly group than in the adult group (1.9% vs. 0.3%, p < 0.001). Prevalence of hyponatremia and severe hyponatremia was significantly higher in the elderly group than in the adult group in all seasons. In the elderly group, there was a significant correlation between weather high temperature during summer and prevalence of hyponatremia (r = 0.510, p = 0.011).ConclusionThere was a major impact of age on the seasonal prevalence of hyponatremia and severe hyponatremia. Strategies to prevent hyponatremia and severe hyponatremia should be taken especially in the elderly patients during summer.
Introduction:
Visceral fat area (VFA) is known to increase after initiation of peritoneal dialysis (PD). However, the factors contributing to the increase in VFA in long-term PD patients have not been sufficiently elucidated. The present study investigated factors that affect VFA in patients who continue PD for ≥3 years.
Methods:
Twenty patients (63.1 ± 10.3 years, 9 men, 11 diabetic patients) between January 2008 and January 2015 were included. VFA, subcutaneous fat area (SFA) and waist circumference at initiation and follow-up were measured at the level of the umbilicus by computed tomography using an image analysis system. Change in VFA was defined as the value obtained by dividing VFA at the final follow-up by that at the initiation. The correlations between clinical parameters at initiation and changes in VFA were analyzed.
Results:
There was no significant change in body weight (57.6 ± 10.4 vs 58.3 ± 7.8 kg,
P
= 0.296) during the mean final follow-up period of 55 ± 13 months, although VFA increased significantly (103.6 ± 39.2 vs 122.6 ± 38.3 cm
2
,
P
= 0.030). Although subcutaneous fat area (SFA) did not change (124.7 ± 52.3 vs 124.5 ± 49.2 cm
2
,
P
= 0.989), waist circumference increased significantly (79.4 ± 8.4 vs 83.7 ± 6.9 cm,
P
= 0.010). SFA (r = −0.735, P < 0.001), waist circumference (r = − 0.644,
P
= 0.002), high-density lipoprotein cholesterol (HDL-C) (r = 0.487,
P
= 0.029), and age (r = 0.507,
P
= 0.023) correlated significantly with changes in VFA.
Conclusions:
VFA might increase with long-term PD in patients with end-stage kidney disease who have high HDL-C, small SFA, and small waist circumference at initiation.
We examined the effects of age and sex on the relationship between body fat area and kidney events. We included 367 chronic kidney disease patients between 2011 and 2017. Patients' median age was 73.0 years; 262 (71.4%) patients were male. The median estimated glomerular filtration rate was 20.2 mL/min/1.73 m2. During the observation period, 187 patients developed kidney events. In males aged <75 years, high subcutaneous fat area was a risk factor for kidney events (hazard ratio: 1.06, 95% CI: 1.02‐1.11). In females aged <75 years, high visceral fat area reduced kidney events (hazard ratio: 0.83, 95% CI: 0.71‐0.97). In males and females ≥75 years, visceral fat area and subcutaneous fat area were not associated with kidney events. Body fat area was not a risk factor for chronic kidney disease progression in elderly patients. Opposite effects, in sex‐related body fat and kidney events, were shown in young patients.
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