Sodium Status Research Articles

Serum Sodium Status in Children with Simple and Complex Febrile Seizure: A Comparative Hospital Based Study

Serum Sodium Status in Children with Simple and Complex Febrile Seizure: A Comparative Hospital Based Study

Prognostication After Dialysis Withdrawal

IntroductionDialysis withdrawal represents an increasingly common cause of death in patients receiving kidney replacement therapy internationally. Prognostic information around stopping dialysis guides clinicians counselling patients and families regarding end-of-life care. However, few studies examine prognostication after withdrawal.We aimed to determine median survival time after withdrawal of dialysis, and to determine what patient and dialysis-related factors are significantly associated with prognosis. MethodsThis retrospective cohort study used registry data. We included all adult patients from the Western Renal Services who were receiving peritoneal dialysis or haemodialysis prior to death, whose cause of death was documented as “Withdrawal from dialysis” and whose date of death was between 1 January 2016 and 30 June 2022. Demographic, clinical and biochemical data was extracted. The primary outcome was time to death, defined as days from last dialysis session to date of death. ResultsMedian survival time from last dialysis to death for the peritoneal dialysis group (n=53) was 4 days (IQR 3-10 days), not significantly different from the haemodialysis group which was 6 days (IQR 2-11 days, p=0.72). For peritoneal dialysis, the only variable significantly associated with survival time was reason for withdrawing (p=0.01). Median survival time was significantly longer for patients withdrawing for psychosocial reasons compared to those withdrawing for other reasons (p=0.002). For haemodialysis (n=186), variables significantly associated with survival time from last dialysis to death was reason for withdrawing (p=0.001), urine production at time of withdrawal (p=0.005), serum sodium (p=0.02) and smoking status (p=0.009). ConclusionMedian survival time was longer for withdrawals for psychosocial reasons compared to medical reasons. The data presented could inform withdrawal discussions regarding prognostication and end-of-life planning with patients and family.

A randomised controlled crossover trial comparing a polymeric with a semi-elemental oral nutritional supplement on fluid and sodium status in patients with a jejunostomy

BackgroundPatients with a short bowel need to restrict oral fluid to reduce stoma/fistula output. Some patients require oral nutritional supplements (ONS) to meet nutritional requirements. There is limited research on ONS for patients with a short bowel. This study aimed to compare polymeric verses semi-elemental ONS on jejunal wet weight and sodium output. Materials and methodsPatients were included if they had < 200 cm of small bowel to a jejunostomy or an enterocutaneous fistula. Patients fasted from midnight then were randomly allocated to consume 200 ml of either Vital 1.5® or Ensure Plus® over 30 min. Jejunal output and urine were collected for 6 h during which patients remained nil by mouth. Jejunal and urine outputs were weighed, and samples sent for analysis. After a day washout, patients were swapped to the other ONS. Differences between the two study periods were assessed using multilevel regression. ResultsTen patients completed, 4 females: 6 males, mean age 59.2 years, mean small bowel length 95 cm. Jejunal wet weight (P < 0.001) and jejunal sodium (P = 0.003) were significantly higher on Vital 1.5® compared to Ensure Plus® with a mean difference of 0.1 kg and13mmol respectively. There was no difference in faecal sodium balance (P = 0.16), urine sodium (P = 0.38) or urine volume (P = 0.56). ConclusionA semi-elemental ONS results in a greater jejunal wet weight loss compared to a polymeric one. The amount is small but the daily cumulative loss will be greater.

The Relationship Between Sodium, Potassium Intake and Nutritional Status with Blood Pressure in Hypertension Sufferers in the Loa Janan Community Health Center Working Area

Riskesdas data 2018 shows that the prevalence of hypertension in the elderly population &gt;18 years in Indonesia based on national measurements is 34.11%. The aim of the research was to determine the relationship between sodium, potassium intake and nutritional status with blood pressure in hypertension sufferers in the Loa Janan Community Health Center working area. The research method was cross sectional with accidental sampling technique consisting of 45 respondents. Data collection technique using 24 hour food recall interviews for 2 days. Chi square test data analysis technique. The results of the chi square test showed that there was a significant relationship between sodium intake and blood pressure (p=0.000), there was no significant relationship between potassium intake and blood pressure (p=0.509) and there was a significant relationship between nutritional status and blood pressure (p =0.007). Conclusion: There is a significant relationship between sodium intake and blood pressure, and there is no significant relationship between potassium intake and blood pressure and there is a significant relationship between nutritional status and blood pressure in the Loa Janan Community Health Center working area.

Medical Treatment in Heart Failure with Reduced Ejection Fraction: A Proposed Algorithm Based on the Patient's Electrolytes and Congestion Status.

In heart failure (HF) with reduced ejection fraction (HFrEF), four classes of drugs (β-blockers, angiotensin-converting enzyme inhibitors/angiotensin receptor neprilysin inhibitors, mineralocorticoid receptor antagonists, and the most recent Sodium-Glucose Co-Transporters 2 Inhibitors) have demonstrated positive results in randomized controlled trials (RCTs). Nevertheless, the latest RCTs are not proper for comparison since they were carried out at various times with dissimilar background therapies and the patients enrolled did not have the same characteristics. The difficulty of extrapolating from these trials and proposing a common framework appropriate for all cases is thus obvious. Despite the fact that these four agents are now the fundamental pillars of HFrEF treatment, the built-up algorithm of initiation and titration is a matter of debate. Electrolyte disturbances are common in HFrEF patients and can be attributed to several factors, such as the use of diuretics, renal impairment, and neurohormonal activation. We have identified several HFrEF phenotypes according to their sodium (Na+) and potassium (K+) status in a "real world" setting and suggest an algorithm on how to introduce the most appropriate drug and set up therapy based on the patients' electrolytes and the existence of congestion.

Sodium depletion and secondary hyperaldosteronism in outpatients with an ileostomy: a cross-sectional study

Objective Patients with an ileostomy may experience postoperative electrolyte derangement and dehydration but are presumed to stabilise thereafter. We aimed to investigate the prevalence of sodium depletion in stable outpatients with an ileostomy and applied established methods to estimate their fluid status. Methods We invited 178 patients with an ileostomy through a region-wide Quality-of-Life-survey to undergo outpatient evaluation of their sodium and fluid status. The patients delivered urine and blood samples, had bioelectrical impedance analysis performed and answered a questionnaire regarding dietary habits. Results Out of 178 invitees, 49 patients with an ileostomy were included; 22 patients (45%, 95% CI, 31–59%) had unmeasurably low urinary sodium excretion (<20 mmol/L), indicative of chronic sodium depletion, and 26% (95% CI, 16–41%) had plasma aldosterone levels above the reference value. Patients with unmeasurably low urinary sodium excretion had low estimated glomerular filtration rates (median 76, IQR 63–89, mL/min/1.73m2) and low venous blood plasma CO2 (median 24, IQR 21–26, mmol/L), indicative of chronic renal impairment and metabolic acidosis. Bioelectrical impedance analysis, plasma osmolality, creatinine and sodium values were not informative in determining sodium status in this population. Conclusion A high proportion of patients with an ileostomy may be chronically sodium depleted, indicated by absent urinary sodium excretion, secondary hyperaldosteronism and chronic renal impairment, despite normal standard biochemical tests. Sodium depletion may adversely affect longstanding renal function. Future studies should investigate methods to estimate and monitor fluid status and aim to develop treatments to improve sodium depletion and dehydration in patients with an ileostomy. IMPACT AND PRACTICE RELEVANCE STATEMENT Sodium depletion in otherwise healthy persons with an ileostomy was identified in a few publications from the 1980s. The magnitude of the problem has not been demonstrated before. The present study quantifies the degree of sodium depletion and secondary hyperaldosteronism in this group, and the results may help guide clinicians to optimise treatment. Sodium depletion is easily assessed with a urine sample, and sequelae may possibly be avoided if sodium depletion is detected early and treated. This could ultimately help increase the quality of life in patients with an ileostomy.

Sodium Status and Its Correlation with Indices of Pulmonary Dysfunction in COVID-19 Patients

Background: COVID-19-induced hyponatremia is reportedly associated with pulmonary dysfunction, but mostly among Caucasians. Hence, the current study evaluated sodium status and its correlation with indices of pulmonary dysfunctions among Nigerians of Negroid race. Methods: This was a retrospectively-designed observational study. Data, all obtained at presentation, were acquired from medical records of 480 RT-PCR-confirmed COVID-19 patients managed at a COVID-19-designated treatment facility in Port Harcourt, Southern Nigeria. Analysis of acquired data was done by COVID-19 clinical grades and sodium status using descriptive and inferential statistics. Results: At presentation, hyponatremia and hypernatremia were observed in 47.7% and 1.0% of the entire studied cohorts (n=480), respectively. Both disorders (hyponatremia/hypernatremia) were mostly observed among the moderate, severe, and critical cases. Most hyponatremic cases (n=154;67.2%) and the entire hypernatremic cases (n=5;100%) were of mild grades. Hyponatremics had higher proportions of fever, breathlessness, confusion, and a higher burden of inflammatory markers which increased with worsening hyponatremic grade. Etiologically, hyponatremia was mostly associated with the syndrome of inappropriate anti-diuretic hormone secretion (SIADH) (n=132;56.7%). Among the hyponatremics, an inverse correlation existed between sodium and respiratory rate (RR), while a correlation existed between sodium and oxygen saturation (SpO2). Compared to mild hyponatremics, the moderate/severe hyponatremics had a greater risk of having RR&gt;30 and SpO2 &lt;95%. Conclusion: Hyponatremia, mostly of mild grade, was common among the studied COVID-19 patients and was associated with indices of pulmonary dysfunctions, including disease severity, inflammatory markers, and SIADH. Hence, hyponatremia should be utilized to triage COVID-19 patients at presentation. However, further studies are recommended to verify these findings.

Hyponatraemia and fluid overload are associated with higher risk of mortality in dialysis patients.

The 5-year mortality rate for haemodialysis patients is over 50%. Acute and chronic disturbances in salt and fluid homeostasis contribute to poor survival and are established as individual mortality risk factors. However, their interaction in relation to mortality is unclear. We used the European Clinical Database 5 to investigate in a retrospective cohort analysis the relationship between transient hypo- and hypernatremia, fluid status and mortality risk of 72163 haemodialysis patients from 25 countries. Incident haemodialysis patients with at least one valid measurement of bioimpedance spectroscopy were followed until death or administrative censoring from 1 January 2010 to 4 December 2019. Fluid overload and depletion were defined as >2.5L above, and -1.1L below normal fluid status, respectively. N=2272041 recorded plasma sodium and fluid status measurements were available over a monthly time grid and analysed in a Cox regression model for time-to-death. Mortality risk of hyponatremia (plasma sodium <135mmol/L) was slightly increased when fluid status was normal [hazard ratio (HR) 1.26, 95% confidence interval (CI) 1.18-1.35], increased by half when patients were fluid depleted (HR 1.56, 95% CI 1.27-1.93) and accelerated during fluid overload (HR 1.97, 95% CI 1.82-2.12). Plasma sodium and fluid status act independently as risk factors on mortality. Patient surveillance of fluid status is especially important in the high-risk subpopulation of patients with hyponatremia. Prospective patient-level studies should examine the effects of chronic hypo- and hypernatremia, risk determinants, and their outcome risk.

The Relationship of Nutritional Status and Natrium Consumption Hypertension Elderly Status in the Lamongan Health Center Area

The elderly are vulnerable to degenerative diseases, such as hypertension. The aim of the study was to determine the relationship between nutritional status and sodium consumption with hypertension elderly status in the in the Lamongan Health Center area. Quantitative design research method with this type of observational analytic research, cross sectional study approach. A sample of 63 respondents. Sampling using accidental sampling technique. Methods of data collection by weighing and measuring body height and interviews using the Semi Quantitative Food Frequency Questionnaire (SQ-FFQ) Form. The results showed that most of the elderly with hypertension were aged 60-69 years (74.6%), were female (57.1%), had a family history of hypertension (66.7%), had more nutritional status (49.2%), consumption of more sodium (54%) and hypertension status stage 1 (81.0%). The results of the Spearman correlation test stated that there was a relationship between nutritional status and hypertension status and that there was a relationship between sodium consumption and hypertension status (p=0.001;p=0.034). The conclusion of the study is that there is a relationship between nutritional status and hypertension status and sodium consumption and hypertension status in the Lamongan Health Center area. It is recommended to conduct nutrition education in the elderly.

Occurrence Relationship between Sodium and Maceral Groups in Subbituminous Coal: A Case Study on Zhundong Coal and Shenfu Coal

The occurrence characteristics of sodium and its potential relationship with macerals in Zhundong coal, as well as in Shenfu coal with average sodium levels, are investigated in this study. A new five-step sequential extraction method was first conducted for determination. The occurrence status of sodium and its related macerals in samples was determined by microscope and SEM–EDS (scanning electron microscope–energy dispersive X-ray spectroscopy). Soluble sodium salts (H2O-Na) make up the primary proportion of sodium in Zhundong coal, at approximately 50%, while various sodium species are distributed in Shenfu coal with nonobvious differences. Inertinite contains more sodium than vitrinite does in both coals, and the highest enrichment degree of sodium was discovered in inertinite from Zhundong coal, which presented primarily as NaCl crystals (H2O-Na) in fusinite cells, with a local weight percentage of over 15%. More specifically, H2O-Na and insoluble Na both tend to enrich in fusinite. Additionally, it is found that maceral-rich products can be gathered using triboelectrostatic separation, and a portion of sodium can thus be removed from the coal by removing inertinite. This study may provide new insights and references regarding sodium removal from Zhundong coal.

PMON285 Hypokalemic Periodic Paralysis: A Rare Presentation of Primary Hyperaldosteronism

Abstract Background Primary hyperaldosteronism (PHA) is caused by excessive production of aldosterone from the adrenal glands. Aldosterone levels are usually independent of renin, angiotensin II or sodium status, and often result in hypertension (HTN), hypokalemia and metabolic alkalosis. The most common presentation of this condition is with asymptomatic mild to severe or refractory HTN. This case highlights a patient presenting with hypokalemic periodic paralysis as the first sign of PHA. Clinical Case A 35 year old previously healthy Chinese male, presented with sudden onset bilateral lower extremity weakness for 1 day. This was associated with mild transient lower back pain and fatigue. He had no history of trauma, recent travel, exposure to animal or tick bites. He reported no recent illness or vaccination. His family history was negative for hypertension and various endocrinopathies. The patient was not on any medications and did not consume licorice. His exam was significant for a blood pressure (BP) of 217/136 mmHg, with lower limb evaluation revealing power of 3/5, normal reflexes and a positive heel to shin test. He demonstrated an unsteady gait but Romberg's sign was negative. Upper limb exam was normal. Laboratory findings were remarkable for potassium 1.9 mmol/L, bicarbonate (CO2) 37 mmol/L, normal magnesium (Mg), normal TSH and blood gas showing metabolic alkalosis. Subsequent testing showed renin 0.35 ng/ml/hr, aldosterone 23 ng/dl and aldosterone/pra ratio 66. Saline infusion test confirmed the diagnosis of PHA. Other endocrinologic tests were normal. Electrocardiogram showed prolonged QT interval and U waves. Renal ultrasound was negative for renal artery stenosis and CT abdomen/pelvis showed a 2.4 cm left adrenal adenoma. The patient was admitted to the intensive care unit for 24 hours, where he received intravenous potassium replacement and was started on spironolactone and other antihypertensive medications, which he was discharged on, along with oral potassium. His symptoms resolved after potassium levels normalized and he subsequently had a left adrenalectomy. Conclusion With PHA being the most common endocrinological cause of HTN, clinicians should recognize indicators of underlying PHA even in rare presentations such as this. Presentation: Monday, June 13, 2022 12:30 p.m. - 2:30 p.m.

COVID-19 vaccination is associated with reduced non-COVID in-hospital mortality

We retrieved data on a cohort of medical patients at a regional Israeli hospital. The dependent variable was non-COVID-19 hospital mortality; the independent variables were vaccination status, age, and laboratory data. Serum sodium, age, serum creatinine, and COVID-19 vaccination status were the main independent variables associated with non-COVID-19 mortality. The odds ratio for in-hospital deaths of non-vaccinated patients was 2.01 (1.65–2.44) (unadjusted) and 1.61 (1.29–2.03) after adjustment for the independent variables. This “healthy adherer effect” may confound observational assessments of the clinical efficacy of COVID-19 vaccines.

Evaluation and education of hydration and sodium status in a cool environment among Chinese athletes.

The aim of the study was to find the significance of several factors with parameters of urine tests and blood tests. Finally, we aimed at evaluating the percentage of athletes from the study sample regarding their hydration level. The current study is the prospective type and was conducted on Chinese athletes between June 2021 to April 2022. The study was done in 2 parts for obtaining measurements in the summer season and the winter season and then they were correlated between them. Urine and blood samples were evaluated for determining the required parameters. The parameters of the physical environment like temperature, relative humidity, precipitation, etc. were obtained from the concerned weather station for each day. It was observed that 14.5%, 59% and 26.5% of the female participants were found to have hyper-hydrated, euhydrated and dehydrated, respectively. While 17.57%, 69.69% and 12.74% of the males were classified as hyper-hydrated, euhydrated and dehydrated, respectively. The participants with hyper-hydrated were found to have increased urine volume (p<0.001), reduced specific gravity (p<0.001) and reduced-sodium level (p<0.001). The study found that there is a significant difference in sodium levels between gender and seasons. The level of serum osmolality is also significantly different between the whole study populations concerning combined seasons. In this way, many other parameters are evaluated by correlation with seasons and gender. Hence, this study has brought forward various important findings and gives an overall evaluation of hydration status.

The association of knowledge, attitudes and behaviors related to salt with 24-h urinary sodium, potassium excretion and hypertensive status

To understand the association between sodium and potassium consumption levels, hypertension and knowledge, attitudes and behaviors (KAB) toward salt and the commitment to effective sodium reduction and potassium supplementation to achieve the purpose of suppressing hypertension. A stratified multistage random sampling method was used to obtain a representative provincial sample of 7512 residents aged 18–69 years through a cross-sectional survey by the Salt Reduction and Hypertension Prevention Project (SRHPP) in Zhejiang Province of China in 2017–2018. A screening including demographic, anthropometric, salt-related KAB and physical measurements was implemented, and 24-h urine of approximately 1/5 of the participants was collected and tested. The mean age was 44.8 years, 50.1% were women, 44.0% lived in urban areas, and hypertension or prehypertension accounted for approximately 35.0%. The mean 24-h urinary sodium and potassium excretion were 3848.5 (1661.1) mg/d and 1491.1 (710.9) mg/d, respectively. KAB in urban areas was generally more favorable than in rural areas, women were better than men, and the optimal blood pressure group was better than the other two groups (P < 0.05). However, the awareness and correct use rate of salt-restricted spoons, low-sodium salt and nutrition labeling were lower. A multivariable linear regression model indicated that KAB had a smaller effect on sodium (two indicators effective for promoting sodium reduction) and a greater effect on potassium (six indicators effective for promoting potassium supplementation) and mainly focused on knowledge and behavior indicators. A multivariable logistic regression model indicated that mastering more knowledge and taking active measures could effectively reduce the transition to hypertension, even if the individual was already in prehypertension. There is much room for improvement of salt-related KAB in the Chinese population. A clear association indicates that KAB can help to reduce sodium and supplement potassium, especially potassium, and help to suppress the development of hypertension. The role of beliefs in KAB should be fully valued and improved, similar to knowledge and behaviors. This study provides important evidence and insight into China’s efforts to meet the targets of salt reduction and hypertension prevention.

Management of arterial hypertension in patients with chronic kidney disease on hemodialysis

The article is a review of information about the management of arterial hypertension (AH) on hemodialysis. This problem is relevant due to poor elaboration. At the same time, the prevalence of AH on hemodialysis is 91,4 %. The article discusses surveys concerning criteria for determining AH on hemodialysis and methodological approaches to its registration, target values of blood pressure during therapy. The concept of intradialysis hypertension, issues of the pathogenesis of AH on hemodialysis are also considered. The author presents approaches to nondrug therapy and drug treatment of patients with AH on hemodialysis. In particular, approaches to the control of sodium and volemic status within the framework of patient-dependent and apparatus-dependent technologies are considered. Data on the effectiveness of the use of certain classes of antihypertensive drugs are presented, in particular, diuretics, blockers of the renin-angiotensin-aldosterone system, beta-blockers, calcium channel antagonists, mineralocorticoid receptors are considered. The article reflects the needs of modern clinical practice in conducting evidence-based medicine research and identifies the critical points of orientation of such research.

Sodium Status Modulates the Effects of Aldosterone on Renal Transporter Expression and Tubular Remodeling

Aldosterone (aldo) is a steroid hormone that has a key role in extracellular volume and K+ homeostasis. While aldo levels are expected to be suppressed with high Na+intake, 5‐10% of hypertensives have chronic hyperaldosteronism regardless of Na+ intake. This combination of high sodium and high aldo can worsen end organ damage, especially in the kidney. We examined the effects of elevated aldo in the absence or presence of a high salt diet (HSD) on the expression of Na+ transporters in the distal nephron and on distal nephron remodeling to understand if these changes may play a role in the altered pathology. Male C57Bl/6 mice received either a control (0.4% NaCl) or HSD (4 weeks, 8% NaCl), +/‐ aldo via minipump for the final 2 weeks of treatment (240 μg/kg/day). Transporter expression levels and localization were analyzed by Western blot, qPCR and immunofluorescent staining. Expression of the α subunit of the epithelial sodium channel (ENaC) was increased with aldosterone regardless of Na+ intake, while subunits increased at both a transcript and protein level in mice receiving aldo and HSD. Both total levels of sodium chloride cotransporter (NCC) and active pNCC significantly increased with aldo alone, in association with a fall in blood [K+]. However, the addition of HSD markedly attenuated this increase in NCC and pNCC, despite more severe hypokalemia. This change was not associated with a difference in the expression of its upstream kinase SPAK. NKCC2 expression was not significantly altered in any of the conditions. We imaged whole tubules in thick kidney slices (300μm) to assess whether remodeling of the distal tubule could account for NCC expression differences. Sections were incubated with antibodies against pNCC and AQP2 and cleared with ethyl cinnamate to allow for imaging and analysis of whole distal tubules. Length of the distal tubule was analyzed as the pNCC positive portion. While aldo has previously been shown to promote hypertrophy of the distal tubule, we found a significant shortening of tubules in animals treated chronically with 2 weeks of aldo (Ctl 434m ± 63μm versus aldo 375m ± 88m, P&lt;0.05, n=38 and 30 respectively). However, the addition of HSD with aldo caused a significant increase in distal tubule length (486m ±68μm, P&lt;0.05, n=23). HSD by itself did not alter distal tubule length (428m ± 55m, n=17). Our results suggest that aldo‐mediated transcriptional regulation of ENaC subunits in the kidney changes according to dietary Na+ status. The attenuation of increased NCC and pNCC expression in kidneys of mice receiving HSD with aldo, despite profound hypokalemia and an increase in DCT length, suggest that factors other than blood [K+] have important roles in regulating NCC expression. Finally, aldo‐dependent DCT remodeling is dependent on dietary Na+.

TO STUDY THE PREVALENCE OF ELECTROLYTE IMBALANCE IN PATIENTS WITH SEIZURES

Background: Seizure is dened as an episode of neurological dysfunction caused by abnormal neuronal activity that results in a sudden change in motor, behaviour and sensory perception1. Electrolytes seem to have a dominant role in the causation of seizures Electrolyte homeostasis in the central nervous system (CNS) is a characteristic essential feature behind brain functioning. “A number of clinical studies have also shown a relationship between electrolyte imbalance and seizures. OBJECTIVE: To Determine the Prevalence of electrolyte imbalance in patients with Seizures. RESEARCH DESIGN AND METHODS: A cross sectional study was conducted at , MLN Medical College associated SRN Hospital, Prayagraj. A total 100 patients were enrolled in the study. Patients with 18 years of age or older presented with seizure as the presenting complaint were included. Patients presenting with cerebrovascular accident ,subarachnoid hemorrhage, tuberculoma cavernous sinus thrombosis febrile seizures hypoglycemia alcohol withdrawal uremic encephalopathy and patients refusing to participate in the study. RESULT: Nearly two third (64%) patients had generalized tonic clonic seizures followed by focal seizures (27%) and status epilepticus (9%) respectively. Maximum electrolyte imbalance was seen for calcium (99%) followed by sodium (92%), potassium (63%) and magnesium (33%) respectively. A signicant association of serum sodium status was observed with type of seizures with hyponatremia being more common in GTCS and hypernatremia being more common in status epilepticus. Conclusion: In the present study, there was a high prevalence of hyponatremia (82%). Hyponatremia could be one of the most common factors leading to seizure activity. The ndings of the present study shows that both in adults as well as in children show that electrolyte imbalance is a frequent observation in seizure activity, primarily cation deciency is highly prevalent in seizure cases, however it is difcult to establish the role of a single electrolyte cation to be responsible for this activity

DESCRIPTION OF POTASSIUM, NATRIUM AND NUTRITION AL STATUS IN ADULTS YOUNG HYPERTENSION PATIENS

Objective: to determine the description of potassium intake, sodium and nutritional status in young adults with hypertension. Method: using descriptive observational research design with survey approach. The variables measured in this study were sodium intake, potassium intake, nutritional status. Results: Potassium intake obtained in patients with hypertension was classified as less category, namely 71.8%. Sodium intake in patients with hypertension is mostly classified as lacking at 66.7%. The nutritional status of hypertensive patients in this study was 78.1% classified as obese. The conclusion of this study is that hypertension sufferers have begun to limit daily salt intake, but the nutritional status is still excessive, so there is a need for coaching from the local health center for weight management. Suggestions or recommendations in the form of potassium intake are still low so it is necessary to provide guidance regarding the intake of potassium, sodium in food. Thus the diet of hypertension sufferers will be more regular. Keywords: Potassium intake, hypertension, sodium, nutritional status

Urine sodium to urine creatinine ratio as a marker of total body sodium in infants with intestinal failure

PurposeUrine sodium (UNa) is a measure of total body sodium in infants with intestinal failure (IF) but can be misleading as it does not reflect volume status. Urine sodium to urine creatinine ratio (UNa:UCr) may offer a more accurate measure, but is not routinely used. This study compares UNa:UCr to UNa as a maker of sodium status in infants with IF. MethodsA retrospective review of infants with IF, from a single center, from 2018 to 2020 was conducted (REB H20–00,816). IF etiology, intestinal anatomy, nutritional intake, urine electrolytes and anthropometrics were collected. Linear mixed effects models adjusting for repeated measures were used to associate UNa and UNa:UCr with weight gain and sodium intake. ResultsTwenty-two infants with a median gestational age of 31 weeks were included. IF etiology included gastroschisis (41%), necrotizing enterocolitis (23%), and intestinal perforation (14%). Infants had an average of 3 paired UNa and UNa:UCr measures for a total of 74 paired measurements. UNa:UCr more strongly correlated with sodium intake compared to UNa (R = 0.25, p = 0.032 vs. R = 0.10, p = 0.38). Overall, neither UNa (p = 0.21) nor UNa:UCr (p = 0.16) were significantly correlated with weight gain. However, for infants receiving ≤50% nutrition enterally, weight gain correlated with UNa (p = 0.01) and UNa:UCr (p = 0.01). UNa:UCr >35 predicted adequate growth regardless of enteral intake (92% sensitivity, 59% specificity). ConclusionUNa:UCr is a measure of total body sodium that correlates with sodium intake in infants with IF. Our study indicates UNa:UCr >35 is associated with adequate growth and can be used to guide further validation studies.

Effects of misreporting on agreement of methods to measure sodium status in the National Diet and Nutrition Survey

Effects of misreporting on agreement of methods to measure sodium status in the National Diet and Nutrition Survey