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01.12.2016 | Research article | Ausgabe 1/2016 Open Access

BMC Nephrology 1/2016

Dysnatremia, its correction, and mortality in patients undergoing continuous renal replacement therapy: a prospective observational study

Zeitschrift:
BMC Nephrology > Ausgabe 1/2016
Autoren:
Seung Seok Han, Eunjin Bae, Dong Ki Kim, Yon Su Kim, Jin Suk Han, Kwon Wook Joo
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​s12882-015-0215-1) contains supplementary material, which is available to authorized users.

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

SSH designed the study, collected the data, analyzed and interpreted the results, and drafted the manuscript. EB collected the data. DKK and YSK designed the study and collected the data. JSH conceived the study and interpreted the data. KWJ conceived the study, analyzed the results, interpreted the data, and reviewed the manuscript. All of the authors read and approved the final manuscript.

Abstract

Background

Although dysnatremia has been reported to be correlated with mortality risk, this issue remains unresolved in patients undergoing continuous renal replacement therapy (CRRT). Furthermore, it has not been determined whether change in or correction of sodium is related to mortality risk in this subset.

Methods

A total of 569 patients were prospectively enrolled at the start of CRRT between May 2010 and September 2013. The patients were divided into 5 groups: normonatremia (135–145 mmol/L), mild hyponatremia (131.1–134.9 mmol/L), moderate to severe hyponatremia (115.4–131.0 mmol/L), mild hypernatremia (145.1–148.4 mmol/L), and moderate to severe hypernatremia (148.5–166.0 mmol/L). The non-linear relationship between sodium and mortality was initially explored. Subsequently, the odds ratios (ORs) for 30-day mortality were calculated after adjustment of multiple covariates.

Results

The relationship between baseline sodium and mortality was U-shaped. The mild hyponatremia, moderate to severe hyponatremia, and moderate to severe hypernatremia groups had greater ORs for mortality (1.65, 1.91, and 2.32, respectively) than the normonatremia group (all P values < 0.05). However, later sodium levels (24 and 72 h after CRRT) did not predict 30-day mortality. Furthermore, the changes in sodium over 24 or 72 h, including the appropriate correction of dysnatremia, did not show any relationships with mortality, irrespective of baseline sodium level.

Conclusions

Sodium level at the start of CRRT was a strong predictor of mortality. However, changes in sodium level and the degree of sodium correction were not associated with the mortality risk in the patients with CRRT.
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