Prevalence of hyponatremia in adult patients with pulmonary tuberculosis

Abstract

Introduction: Pulmonary Tuberculosis (PTB) is one of the paramount causes of morbidity and mortality in the developing and underdeveloped countries. India is the country with the highest burden of PTB. Among the electrolyte imbalance hyponatremia is observed commonly which will lead to increase in morbidity and mortality. In this study, the prevalence of hyponatremia in adult pulmonary tuberculosis patients was done. Methodology: In this retrospective study; patients of age more than 18 years presented to our department from 2016 to 2017 were included. PTB was diagnosed as per the institutional protocol, i.e., on clinical presentation of the patient, microscopic examination suggestive of acid-fast bacilli (AFB) and an abnormal chest radiograph findings. All the case files of patients having PTB in the study period were collected and demographic parameters and relevant laboratory findings were noted and analyzed. Results: A total of 150 patients with PTB were included in this study between 18 to 86 years of age group. Mean age of patients was 50.92 + 17.76. Among 150 patients, 114 (76%) had hyponatremia with serum sodium levels less than 135mmol/l out of which 84 (74%) were males and 30 (26%) were females. Out of 150 patients 59 (39%) had mild hyponatremia; 41 (27%) had moderate hyponatremia and 14 (9%) had severe hyponatremia. In all the groups of hyponatremia, majority were found to be males. 27 (46%) in mild hyponatremia, 34 (83%) in moderate hyponatremia and 11 (79%) in severe hyponatremia were sputum AFB positive. Many patients were asymptomatic except 4 with severe hyponatremia requiring vasopressor support for hypotension. Conclusions: Patients with PTB should be evaluated for hyponatremia; early detection and treatment of can potentially reduce morbidity and mortality. Keywords: AFB; Hyponatremia; Mortality; Pulmonary tuberculosis.