Osteomalacia in a Case of Adult-Onset Bartter Syndrome

Khan, Rashid; Saba, F

doi:10.12890/2018_000764

Cited by 1 publication

(1 citation statement)

References 7 publications

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“…Second, the usage of drugs and nutritional state in this study population are unclear, which may contribute to bias in the interpretation of the data. Third, some diseases, such as hypophosphatemia or metabolic alkalosis [47], syndrome of inappropriate antidiuretic hormone secretion (SIADH) [11,25], primary hyperaldosteronism [48,49], Cushing syndrome [50][51][52], and Bartter syndrome [53], may be strongly linked to hyponatremia or hypokalemia and fracture incidence but were not excluded or analyzed in this study. Finally, the study is confined to a single trauma center, potentially limiting the generalizability of its findings to broader populations.…”

Section: Discussionmentioning

confidence: 99%

The Influence of Hyponatremia and Hypokalemia on the Risk of Fractures in Various Anatomical Regions among Adult Trauma Patients: A Propensity Score-Matched Analysis

Hsu,

Rau,

Tsai

et al. 2024

Diagnostics

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Background: Hyponatremia and hypokalemia are common electrolyte imbalances in trauma patients and have been identified to be risk factors for a fall. In addition, hyponatremia was reported to be related to osteoporosis and fragility fractures, while the association between hypokalemia and osteoporosis has only been reported in rare case reports. This study investigated the impact of hyponatremia and hypokalemia on the incidence of fractures in various body regions of adult trauma patients, using the propensity score-matched patient cohort to reduce the influence of patients’ baseline characteristics. Methods: The study analyzed data from 11,173 hospitalized adult trauma patients treated from 1 January 1998, to 31 December 2022. The study included 1968 patients with hyponatremia and 9205 without, and 1986 with hypokalemia and 9187 without. Different 1:1 propensity score-matched cohorts were generated to create the 1903 pairings of patients with or without hyponatremia, 1977 pairings of patients with or without hypokalemia, and 380 pairing of patients with both hyponatremia and hypokalemia vs. normal control patients. Analysis was conducted on the incidence of fracture in various anatomic regions. Results: Hyponatremic patients had increased odds of thoracic vertebral fracture [odds ratio (95% confidence interval) 1.63 (1.10–2.42), p = 0.014], pelvic fracture [2.29 (1.12–4.67), p = 0.019], and femoral fracture [1.28 (1.13–1.45), p < 0.001] but decreased odds of radial and patella fractures. Hypokalemic patients showed no significant differences in fracture risk except for a decreased likelihood of radial fractures. The patients with both hyponatremia and hypokalemia showed a decreased likelihood of radial fractures and patella fractures. Conclusion: Hyponatremia may have a greater impact on the occurrence of bone fractures than hypokalemia in trauma patients who have suffered a fall. Electrolyte abnormalities should be taken into account while assessing the risk of fractures in trauma patients.

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