&lt;p&gt;Osmotic stress and mortality in elderly patients with kidney failure: a retrospective study&lt;/p&gt;

Grangeon-Chapon, Caroline; Dodoi, Manuella; Esnault, Vincent; Favrè, Guillaume

doi:10.2147/cia.s158987

Cited by 4 publications

(3 citation statements)

References 27 publications

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“…The results of our analyses generally revealed an up-trending pattern of ORs for all outcomes in higher [Na] and older age groups. In accordance with other studies(11,12,32), our study demonstrated that the odds of inhospital mortality in all [Na] group increased with aging. This can be attributed to the fact that elderly patients with hypernatremia present fewer symptoms of hypernatremia compared to younger patients.…”

supporting

confidence: 93%

Hypernatremia in Hospitalized Patients: A Large Population-Based Study

et al. 2022

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Background: Hypernatremia is a frequently encountered electrolyte disorders in hospitalized patients. Controversies still exist over the relationship between hypernatremia and its outcomes in hospitalized patients. This study examines the relationship of hypernatremia to outcomes among hospitalized patients and to examine the extent to which this relationship varies by kidney function and age. Methods: We conducted an observational study to investigate the association between hypernatremia, eGFR and age at hospital admission and in-hospital mortality, and discharge dispositions. We analyzed the data of 1.9 million patients extracted from the Cerner Health Facts databases (2000-2018). Adjusted multinomial regression models were used to estimate the relationship of hypernatremia to outcomes of hospitalized patients. Results: Of all hospitalized patients, 3.2% had serum sodium ([Na]) >145 at hospital admission. Incidence of in-hospital mortality was 11.7% and 2.2% in hyper- and normonatremic patients, respectively. The risk of all outcomes increased significantly for [Na] >155 mEq/L compared to the reference interval of [Na]: 135-145 mEq/L. Odds Ratios (95% confidence interval) for in-hospital mortality, discharge to hospice and discharge to nursing facilities were 34.41 (30.59-38.71), 21.14 (17.53-25.50) and 12.21 (10.95-13.61), respectively, (p<0.001, for all). In adjusted models, we found the association between [Na] and disposition was modified by eGFR (p<0.001) and by age (p<0.001). Sensitivity analyses were performed using the eGFR equation without race as a covariate and the inferences did not substantially change. In all hypernatremic groups, patients aged 76-89 and ≥90 had higher odds of in-hospital mortality compared to younger patients (p<0.001, for all). Conclusions: Hypernatremia was significantly associated with in-hospital mortality, discharge to hospice or to nursing facility. The risk of in-hospital mortality and other outcomes was highest among those with [Na]>155 mEq/L. This work demonstrates that hypernatremia is an important factor related to discharge disposition and supports the need to study whether protocolized treatment of hypernatremia improves outcomes.

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confidence: 93%

Hypernatremia in Hospitalized Patients: A Large Population-Based Study

et al. 2022

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“…Table 1 shows the incidence and prevalence of hyponatremia in the studies of the general population, CKD not on dialysis, hemodialysis, and peritoneal dialysis ( 10 , 27 – 54 ). Table 2 shows the incidence and prevalence of hypernatremia in the same population segments ( 10 , 28 – 30 , 32 – 36 , 38 – 40 , 47 , 53 – 55 ). The values for prevalence and incidence related to dysnatremias vary widely in each of the four categories of patients in Tables 1 , 2 and overlap substantially among the four patient categories.…”

Section: Reviewmentioning

confidence: 99%

“…Hypernatremia increases the risk for mortality in the general population ( 82 ) and in patients with CKD not on dialysis ( 10 , 34 – 36 , 38 ). In hemodialysis patients, hypernatremia was observed to be a risk factor for all-cause mortality ( 44 ) and mortality risk for causes other than cardiovascular disease or malignancy in a second study ( 46 ).…”

Section: Reviewmentioning

confidence: 99%

Dysnatremias in Chronic Kidney Disease: Pathophysiology, Manifestations, and Treatment

Arzhan

Lew²,

Ing³

et al. 2021

Front. Med.

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The decreased ability of the kidney to regulate water and monovalent cation excretion predisposes patients with chronic kidney disease (CKD) to dysnatremias. In this report, we describe the clinical associations and methods of management of dysnatremias in this patient population by reviewing publications on hyponatremia and hypernatremia in patients with CKD not on dialysis, and those on maintenance hemodialysis or peritoneal dialysis. The prevalence of both hyponatremia and hypernatremia has been reported to be higher in patients with CKD than in the general population. Certain features of the studies analyzed, such as variation in the cut-off values of serum sodium concentration ([Na]) that define hyponatremia or hypernatremia, create comparison difficulties. Dysnatremias in patients with CKD are associated with adverse clinical conditions and mortality. Currently, investigation and treatment of dysnatremias in patients with CKD should follow clinical judgment and the guidelines for the general population. Whether azotemia allows different rates of correction of [Na] in patients with hyponatremic CKD and the methodology and outcomes of treatment of dysnatremias by renal replacement methods require further investigation. In conclusion, dysnatremias occur frequently and are associated with various comorbidities and mortality in patients with CKD. Knowledge gaps in their treatment and prevention call for further studies.

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