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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 PLoS+One
2016 ; 11
(9
): e0162990
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The Effects of Pre-Existing Hyponatremia and Subsequent-Developing Acute Kidney
Injury on In-Hospital Mortality: A Retrospective Cohort Study
#MMPMID27622451
Lee SW
; Baek SH
; Ahn SY
; Na KY
; Chae DW
; Chin HJ
; Kim S
PLoS One
2016[]; 11
(9
): e0162990
PMID27622451
show ga
BACKGROUND AND OBJECTIVES: Both hyponatremia and acute kidney injury (AKI) are
common and harmful in hospitalized patients. However, their combined effects on
patient mortality have been little studied. METHODS: We retrospectively enrolled
19191 adult patients who were admitted for 1 year. Pre-existing hyponatremia was
defined as a serum sodium level < 135 mmol/L on the first measurement of their
admission. AKI was defined as a rise in serum creatinine by ? 26.5 ?mol/L or ?
1.5 times of the baseline value of creatinine during the hospital stay. RESULTS:
The prevalence of pre-existing hyponatremia was 8.2%. During a median 6.0 days of
hospital stay, the incidence rates of AKI and in-hospital patient mortality were
5.1% and 0.9%, respectively. Pre-existing hyponatremia independently predicted
AKI development and in-hospital mortality (adjusted hazard ratio [HR] 1.300, P =
0.004; HR 2.481, P = 0.002, respectively). Pre-existing hyponatremia and
subsequent development of AKI increased in-hospital mortality by 85 times,
compared to the patients with normonatremia and no AKI. In subgroup analysis, the
AKI group showed higher rates of de novo hypernatremia than the non-AKI group
during the admission. De novo hypernatremia, which might be associated with
over-correction of hyponatremia, increased in-hospital mortality (HR 3.297, P
<0.001), and patients with AKI showed significantly higher rates of de novo
hypernatremia than patients without AKI (16.2% vs. 1.4%, P < 0.001,
respectively). CONCLUSION: Pre-existing hyponatremia may be associated with the
development of AKI in hospitalized patients, and both hyponatremia and
hospital-acquired AKI could have a detrimental effect on short term patient
mortality, which might be related to the inappropriate correction of hyponatremia
in AKI patients.