Prevalence Of Hyponatremia In Patients Research Articles

Eslicarbazepine-induced hyponatremia: A retrospective single-center real clinical practice study.

Hyponatremia is a typical side effect of antiseizure drugs from the dibenzazepine family. The study investigated the prevalence of hyponatremia in patients with epilepsy who were treated with eslicarbazepine. We aimed to determine the prevalence of hyponatremia, reveal the factors leading to the discontinuation of treatment, and identify possible risk factors for the development of hyponatremia including the dose dependency. The medical records of 164 patients with epilepsy taking eslicarbazepine in our center were analyzed. The overall prevalence of hyponatremia was 30.5%. The prevalence of mild hyponatremia, seen in 14%-20% of patients, was not dose dependent. The prevalence of moderate and severe hyponatremia was significantly dose dependent. The severity of hyponatremia was significantly dose dependent. Severe hyponatremia was found in 6.1% of patients. Hyponatremia was asymptomatic in the majority of cases, and in 48% did not require any management. Hyponatremia was the reason for discontinuation in 6.2% of patients. The major risk factor for developing hyponatremia was older age. The study shows that eslicarbazepine-induced hyponatremia is usually mild and asymptomatic. It usually does not require any management and seldom leads to treatment discontinuation. Hyponatremia is dose dependent. Another major risk for developing hyponatremia (besides dose) is older age.

Hyponatremia in Patients Admitted to Intensive Care Unit of a Tertiary Center: A Descriptive Cross-sectional Study.

Hyponatremia is one of the common electrolyte abnormalities in intensive care unit settings. Hyponatremia may lead to an increased hospital stay, morbidity and mortality. Hyponatremia can occur due to a variety of iatrogenic as well as part of complex disease processes during hospital admission. The objective of this study was to find the prevalence of hyponatremia in patients admitted to the intensive care unit of a tertiary care centre. A descriptive cross-sectional study was conducted in the intensive care unit of a tertiary care centre for a duration of six months from 12 August 2015 to 11 January 2016. Ethical approval was taken from the Institutional Review Committee (Reference number: 124/6-11-E/072/073). Data was collected from hospital records. Patients with abnormal serum sodium levels after admission to the intensive care unit were included in the study. Hyponatremia was defined as a serum sodium level less than 135 mEq/L. Convenience sampling methods were used. Point estimate and 95% Confidence Interval were calculated. Among 102 patients, the prevalence of hyponatremia was found to be 21 (20.59%) (12.74-28.44, 95% Confidence Interval). The prevalence of hyponatremia in patients admitted to the intensive care unit was higher than in other studies conducted in similar settings. cross-sectional study; prevalence; sodium.

Prevalence of Hyponatremia in Patients Presenting with Chronic Liver Disease

Background: A liver illness that worsens over time and affects the liver's ability to function is known as chronic liver disease. Hyponatremia has been linked to higher rates of morbidity and death in cirrhotic patients Objective: To assess the prevalence of Hyponatremia in patients presenting with Chronic Liver Disease Methodology: The current study was cross-sectional, carried out at the department of medicine, Qazi Hussain Ahmad Medical Complex, Nowshera for duration of one year from July 2021 to July 2022. Blood samples of 5ml were taken from all the enrolled patients and sent to the hospital diagnostic laboratory for the examination of sodium level. All the data including demographic details were recorded on a pre-designed Performa. All the data analysis was done by using IBM SPSS version 23. Results: In the current study, the average (SD) level of sodium was 141.96 (11.22) mmol/L. The overall frequency of Hyponatremia was 73 (34.76%) in chronic liver disease patients. Based on the severity of hyponatremia, mild, moderate and severe hyponatremia was observed in 105 (50%), 101 (48.10%) and 4 (1.90%) respectively. Hyponatremia was observed in 18 (23.68%) patients of Child-Pugh class A, in 23 (39.66%) in Child-Pugh class B while hyponatremia was observed in 28 (36.84%) patients of Child-Pugh class C (p˃0.05). Conclusion: Our study concludes that the frequency of hyponatremia in patients of chronic liver disease was high Keywords: Prevalence; Hyponatremia; Chronic Liver Disease

Prevalence of Hyponatremia in Patients Admitted to the Oncology Teaching Hospital

Background: Hyponatremia is a commonly occurring electrolyte disturbance among hospitalized patients, and many studies suggest that individual serum sodium levels may have a prognostic role in assessing probability of mortality. Aim of the study: Determination of hyponatremia prevalence in patients admitted to the Oncology Teaching Hospital. Method: A six-month cross-sectional study of hyponatremia prevalence was conducted in the Oncology ward in Medical City. The patients (105) who were admitted for more than three days with different types of malignancies and causes of admission were investigated for serum sodium, blood urea, random blood sugar, and urinary sodium (single measurement). These results were compared to the sodium levels of control of non-cancer individuals (135) selected using the same exclusion criteria. Results: The prevalence of hyponatremia in the admitted patients was 43.7%, whereas it was 0.73% in the control group. Conclusion: The prevalence of hyponatremia in Oncology Teaching Hospital, Medical City ward, was higher than that reported in previous studies (conducted in international cancer centers); hypoosmolar hyponatremia prevalence is almost similar to that stated in previous studies.

Hyponatremia in Chronic Liver Disease among Patients Presenting to a Tertiary Care Hospital: A Descriptive Cross-sectional Study.

Hyponatremia is a frequent problem in chronic liver disease. To the best of our knowledge, no study of hyponatremia in chronic liver disease has been conducted in our setting. The aim of this study is to study the prevalence of hyponatremia in patients with chronic liver disease attending the outpatient department of a tertiary care hospital. This descriptive cross-sectional study was conducted in 114 patients with chronic liver disease attending the out-patient department of a tertiary care hospital in Kathmandu, Nepal between November 2020 and July 2021. Ethical approval was taken from the Institutional Review Committee of Nepal Medical College and Teaching Hospital (Reference number: 028-077/078). Convenience sampling was done. The collected data was entered and analyzed in Microsoft Excel. Calculation of point estimate at 95% confidence interval was done along with frequency and proportion for binary data. Among 114 patients with chronic liver disease studied, 47 (41.22%) (32.18-50.25 at 95% Confidence Interval) patients had hyponatremia (≤130mmol/L) with mean age of 53.44±7.57 years. Thirty (63.8%) patients out of these were males and 17 (36.2%) patients were females. The prevalence of hyponatremia among patients with chronic liver disease was found to be higher when compared to other similar studies.

ENDOCRINOLOGY IN THE TIME OF COVID-19: Management of diabetes insipidus and hyponatraemia.

COVID-19 has changed the nature of medical consultations, emphasizing virtual patient counseling, with relevance for patients with diabetes insipidus (DI) or hyponatraemia. The main complication of desmopressin treatment in DI is dilutional hyponatraemia. Since plasma sodium monitoring is not always possible in times of COVID-19, we recommend to delay the desmopressin dose once a week until aquaresis occurs allowing excess retained water to be excreted. Patients should measure their body weight daily. Patients with DI admitted to the hospital with COVID-19 have a high risk for mortality due to volume depletion. Specialists must supervise fluid replacement and dosing of desmopressin. Patients after pituitary surgery should drink to thirst and measure their body weight daily to early recognize the development of the postoperative syndrome of inappropriate antidiuresis (SIAD). They should know hyponatraemia symptoms. The prevalence of hyponatraemia in patients with pneumonia due to COVID-19 is not yet known, but seems to be low. In contrast, hypernatraemia may develop in COVID-19 patients in ICU, from different multifactorial reasons, for example, due to insensible water losses from pyrexia, increased respiration rate and use of diuretics. Hypernatraemic dehydration may contribute to the high risk of acute kidney injury in COVID-19. IV fluid replacement should be administered with caution in severe cases of COVID-19 because of the risk of pulmonary oedema.

Impact of Hyponatremia on COPD Exacerbation Prognosis.

The most common electrolyte disorder among hospitalized patients, hyponatremia is a predictor of poor prognosis in various diseases. The aim of this study was to establish the prevalence of hyponatremia in patients admitted for acute exacerbation of chronic obstructive pulmonary disease (AECOPD), as well as its association with poor clinical progress. Prospective observational study carried out from 1 October 2016 to 1 October 2018 in the following hospitals: Salnés in Vilagarcía de Arousa, Arquitecto Marcide in Ferrol, and the University Hospital Complex of Santiago de Compostela, Galicia, Spain, on patients admitted for AECOPD. Patient baseline treatment was identified, including hyponatremia-inducing drugs. Poor progress was defined as follows: prolonged stay, death during hospitalization, or readmission within one month after the index episode discharge. 602 patients were enrolled, 65 cases of hyponatremia (10.8%) were recorded, all of a mild nature (mean 131.6; SD 2.67). Of all the patients, 362 (60%) showed poor progress: 18 (3%) died at admission; 327 (54.3%) had a prolonged stay; and 91 (15.1%) were readmitted within one month after discharge. Patients with hyponatremia had a more frequent history of atrial fibrillation (AF) (p 0.005), pleural effusion (p 0.01), and prolonged stay (p 0.01). The factors independently associated with poor progress were hyponatremia, pneumonia, and not receiving home O2 treatment prior to admission. Hyponatremia is relatively frequent in patients admitted for AECOPD, and it has important prognostic implications, even when mild in nature.

The prognosis of heart failure patients: Does sodium level play a significant role?

IntroductionHeart failure (HF), a major cardiovascular disorder, remains a grievous clinical condition regardless of advances in medical care. Hyponatremia is classified as a serum sodium concentration of <135 mEq/L, and the prevalence, clinical impact and prognostic factor of hyponatremia in heart failure patients varies widely. The current study was conducted with the aim of assessing the prevalence of hyponatremia in patients hospitalized with a diagnosis of HF and comparing baseline clinical characteristic of HF patients based on their sodium status. Survival difference between patients with hyponatremia and normonatremia was also assessed and the clinical prognostic indicators of overall mortality in HF patients were evaluated.MethodA retrospective cohort study was conducted to assess medical records of heart failure patients who were admitted to Gondar University Referral Hospital. Patients were categorized based on their sodium level status at their first admission to the internal medicine department. Each patient was assigned to either of the following groups: hyponatremia if sodium < 135 mmol/L, or normonatremia if sodium ≥ 135 mmol/L.ResultAmong 388 participants, the prevalence of hyponatremia in the study cohorts was 51.03%. Kaplan-Meier survival curves showed that there was a significant difference in survival status of HF patients among the two cohorts (Log—Rank test, P <0.0001). Hence, patients with normal sodium levels had a higher chance of survival over hyponatremic patients. Multivariate Cox regression has revealed a statistically significant association of mortality with the following variables: advanced age (AHR = 1.035 (1.012–1.058), P = 0.003), hyponatremia (AHR = 4.003 (1.778–9.009), P = 0.001), higher creatinine level (AHR = 1.929 (1.523–2.443), P = <0.0001) and, prescription of angiotensin-converting enzyme inhibitors (AHR = 0.410 (0.199–0.842), P = 0.015) and spironolactone (AHR = 0.511 (0.275–0.949), P = 0.033.ConclusionIn conclusion, hyponatremia is one of the crucial factors in the clinical prognosis of heart failure patients. However, as other prognostic factors (i.e. medication, creatine level, and age) also played vital roles in overall survival, well-controlled clinical trials (complete with medication dosing, laboratory outputs and long-term prospective follow up) are required to further study the impact of hyponatremia in HF patient’s prognosis in low income nations.

Hyponatremia in patients receiving parenteral nutrition: the importance of correcting serum sodium for total proteins. The role of the composition of parenteral nutrition in the development of hyponatremia.

Hyponatremia is the most common electrolyte disorder, and is associated with high-morbimortality rates. The true prevalence of hyponatremia in patients on parenteral nutrition (PN) is unknown, and the relationship between PN composition and development of hyponatremia has yet to be studied. Hypoproteinemia, a common finding in patients receiving PN, induces an overestimation of serum sodium (SNa) levels, when using indirect electrolyte methodology. Thus, SNa should be corrected for serum total protein levels (TP). The objective was to accurately determine the prevalence of hyponatremia (indirect SNa corrected for PT) and evaluate the relationship between the composition of PN and the development of hyponatremia. Medical records of 222 hospitalized patients receiving total PN during a 7-month period were reviewed. Composition of PN, indirect SNa-mmol/l-, and SNa corrected for TP (SNa-TP)-mmol/l-, both upon initiation and during PN administration, were analyzed. Hyponatremia (SNa < 135 mmol/l) was present in 81% of subjects when SNa was corrected for TP, vs. 43% without correction (p = 0.001). In total 64% of patients that were eunatremic upon initiation of PN developed hyponatremia during PN administration, as detected by SNa-TP, vs. 28% as detected by uncorrected SNa (p < 0.001). There were no significant differences in volume, osmolarity, sodium or total osmols administered in PN between patients who developed hyponatremia and those who remained eunatremic. A majority of patients receiving PN present hyponatremia, when indirect SNa levels are corrected for TP. The development of hyponatremia during PN is not related to the composition of the PN.

Prevalence of hyponatraemia in patients over the age of 65 who have an in-hospital fall

Background and aimHyponatraemia is the most common electrolyte disorder. Some studies have found that it increases morbidity and mortality. There are new lines of research that are investigating the link between hyponatraemia and patient falls. AimTo determine if hyponatraemia is associated with falls in elderly hospitalised patients. MethodsDesign observational, analytical, case–control study. Study populationPatients older than 65 years who had fallen during their hospitalisation at Gregorio Marañón Hospital (Madrid) were considered cases. Patients who did not fall were considered to be controls, paired according to the following variables: hospital ward, age, length of hospital stay, gender and Downton fall risk index. The sample size was 206 subjects. Data collectionSocio-demographic factors, variables included in the falls record sheet, Downton fall risk index and sodium levels were studied (hyponatraemia was considered Na+<135mmol/l). AnalysisA descriptive analysis was performed to determine the sample homogeneity. The OR was calculated, and an analytical analysis using Chi-square test and a multivariate logistic regression analysis were also performed. ResultsOf 103 cases recruited, 61 were men (50.4%) and 42 were women (49.4%). Hyponatraemia was detected in 29 cases with an association with falls of P: 0.002. The adjusted OR was 3.708 (1.6–8.3), 95% CI. Risk factors for falls were identified as hyponatraemia and limb sensory deficits. ConclusionsGiven that hyponatraemia could be considered a risk factor for falls, the inclusion of the determination of sodium level would be important for fall prevention strategies in the elderly.

Prevalence of hyponatremia in femur neck fractures: a one-year survey in an urban emergency department.

This study was aimed at investigating the prevalence of hyponatremia in patients with intracapsular femoral neck fracture. All records containing clinical and laboratory information of patients admitted with femoral neck fractures to the Academic Hospital of Parma (Italy) during the year 2013 were retrieved from the hospital database. The control population consisted of subjects admitted to the outpatient phlebotomy center during the same period. The final population consisted of 543 patients with femoral neck fractures and 700 outpatients. The category of elderly subjects (i.e., ≥65 years) included 491 patients and 380 controls. In both the entire population and elderly subjects, serum sodium was lower in patients than in controls (138 versus 139 mmol/L, P < 0.001). The prevalence of hyponatremia was also higher in cases than in controls, both in the entire population (19.5 versus 10.4%, P < 0.001) and in elderly subjects (20.8 versus 11.8%, P < 0.001). The odds ratio of hyponatremia for femoral neck fracture was 2.08 in the entire study population and 1.95 in those aged 65 years and older. In conclusion, we found that hyponatremia is significantly associated with femoral neck fracture. Serum sodium should hence be regularly assessed and hyponatremia eventually corrected.