Relationship between serum sodium level at dialysis initiation and all-cause mortality
Background Hyponatremia is a common electrolyte disorder in patients with chronic kidney disease. In addition, hyponatremia is associated with mortality in patients with chronic kidney disease, including those on dialysis. However, few studies have examined this relationship in patients with inciden...
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| Veröffentlicht in: | Clinical and experimental nephrology 2023-09, Vol.27 (9), p.747-756 |
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| container_title | Clinical and experimental nephrology |
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| creator | Sasakawa, Yuji Tatematsu, Yoshitaka Kato, Joichiro Fujii, Maya Okamoto, Naoki Inaguma, Daijo |
| description | Background
Hyponatremia is a common electrolyte disorder in patients with chronic kidney disease. In addition, hyponatremia is associated with mortality in patients with chronic kidney disease, including those on dialysis. However, few studies have examined this relationship in patients with incident dialysis.
Methods
We used a database of multicenter prospective cohort studies that included 1520 incident dialysis patients. The baseline was set at the time of dialysis initiation. The enrolled patients were classified into five groups according to their serum sodium levels ( |
| doi_str_mv | 10.1007/s10157-023-02363-9 |
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| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2822374617</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2822374617</sourcerecordid><originalsourceid>FETCH-LOGICAL-c350t-e4f746abd30251ec936cb074055a28e600f66854c6c8783bd9191379ceb03cb53</originalsourceid><addsrcrecordid>eNp9kE1rFTEUhoMo9kP_gAsJuOlm6knOJJksS2m1UBBE3YZM5lxNyczcJjMt99-b9lYLLlyEE8jzvic8jL0TcCoAzMciQCjTgMSHo7GxL9ihaNE0xlj7st6xlY0wShywo1JuAKCzyr5mB2ikbmWHh-zHV0p-ifNUfsUt72m5J5p4obyOvMxDrCPRHSXuFz5En3YlFh6nuMTHFPfTwH1KTfBrIT7OefEpLrs37NXGp0Jvn-Yx-3558e38c3P95dPV-dl1E1DB0lC7Ma32_YAglaBgUYceTAtKedmRBtho3ak26NCZDvvBCivQ2EA9YOgVHrOTfe82z7crlcWNsQRKyU80r8XJTkqsK4Sp6Id_0Jt5zVP9XaUsIHZK6UrJPRXyXEqmjdvmOPq8cwLcg3W3t-6qcfdo3dkaev9UvfYjDX8jfzRXAPdAqU_TT8rPu_9T-xuOGYyo</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2890338556</pqid></control><display><type>article</type><title>Relationship between serum sodium level at dialysis initiation and all-cause mortality</title><source>SpringerLink Journals - AutoHoldings</source><creator>Sasakawa, Yuji ; Tatematsu, Yoshitaka ; Kato, Joichiro ; Fujii, Maya ; Okamoto, Naoki ; Inaguma, Daijo</creator><creatorcontrib>Sasakawa, Yuji ; Tatematsu, Yoshitaka ; Kato, Joichiro ; Fujii, Maya ; Okamoto, Naoki ; Inaguma, Daijo</creatorcontrib><description>Background
Hyponatremia is a common electrolyte disorder in patients with chronic kidney disease. In addition, hyponatremia is associated with mortality in patients with chronic kidney disease, including those on dialysis. However, few studies have examined this relationship in patients with incident dialysis.
Methods
We used a database of multicenter prospective cohort studies that included 1520 incident dialysis patients. The baseline was set at the time of dialysis initiation. The enrolled patients were classified into five groups according to their serum sodium levels (< 130 mEq/L, 130–134 mEq/L, 135–139 mEq/L, 140–144 mEq/L, and ≥ 145 mEq/L). Multivariate Cox proportional hazards analysis was conducted to determine factors associated with all-cause mortality.
Results
A total of 392 all-cause deaths occurred during the follow-up period. The ultrafiltration volume per body weight during the first dialysis session was more significant in the groups with the lowest and highest sodium levels. The percentage of patients using loop diuretics and thiazide was higher in the group with lower sodium levels (< 130 mEq/L and 130–134 mEq/L). All-cause mortality was significantly different among the five groups (
p
= 0.025). Multivariate analysis indicated that all-cause mortality was significantly higher in the group with the lowest sodium level compared to the group with a serum sodium level of 135–139 mEq/L (hazard ratio: 1.61, 95% confidence interval: 1.04–2.49).
Conclusion
Hyponatremia of < 130 mEq/L at dialysis initiation was significantly associated with all-cause mortality. We considered the results relevant to underlying conditions, including cardiovascular disease and medications.</description><identifier>ISSN: 1342-1751</identifier><identifier>EISSN: 1437-7799</identifier><identifier>DOI: 10.1007/s10157-023-02363-9</identifier><identifier>PMID: 37264283</identifier><language>eng</language><publisher>Singapore: Springer Nature Singapore</publisher><subject>Body weight ; Cardiovascular diseases ; Dialysis ; Diuretics ; Hemodialysis ; Hyponatremia ; Kidney diseases ; Medicine ; Medicine & Public Health ; Mortality ; Multivariate analysis ; Nephrology ; Original Article ; Sodium ; Ultrafiltration ; Urology</subject><ispartof>Clinical and experimental nephrology, 2023-09, Vol.27 (9), p.747-756</ispartof><rights>The Author(s), under exclusive licence to The Japanese Society of Nephrology 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2023. The Author(s), under exclusive licence to The Japanese Society of Nephrology.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c350t-e4f746abd30251ec936cb074055a28e600f66854c6c8783bd9191379ceb03cb53</cites><orcidid>0000-0002-3977-5933</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10157-023-02363-9$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10157-023-02363-9$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37264283$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sasakawa, Yuji</creatorcontrib><creatorcontrib>Tatematsu, Yoshitaka</creatorcontrib><creatorcontrib>Kato, Joichiro</creatorcontrib><creatorcontrib>Fujii, Maya</creatorcontrib><creatorcontrib>Okamoto, Naoki</creatorcontrib><creatorcontrib>Inaguma, Daijo</creatorcontrib><title>Relationship between serum sodium level at dialysis initiation and all-cause mortality</title><title>Clinical and experimental nephrology</title><addtitle>Clin Exp Nephrol</addtitle><addtitle>Clin Exp Nephrol</addtitle><description>Background
Hyponatremia is a common electrolyte disorder in patients with chronic kidney disease. In addition, hyponatremia is associated with mortality in patients with chronic kidney disease, including those on dialysis. However, few studies have examined this relationship in patients with incident dialysis.
Methods
We used a database of multicenter prospective cohort studies that included 1520 incident dialysis patients. The baseline was set at the time of dialysis initiation. The enrolled patients were classified into five groups according to their serum sodium levels (< 130 mEq/L, 130–134 mEq/L, 135–139 mEq/L, 140–144 mEq/L, and ≥ 145 mEq/L). Multivariate Cox proportional hazards analysis was conducted to determine factors associated with all-cause mortality.
Results
A total of 392 all-cause deaths occurred during the follow-up period. The ultrafiltration volume per body weight during the first dialysis session was more significant in the groups with the lowest and highest sodium levels. The percentage of patients using loop diuretics and thiazide was higher in the group with lower sodium levels (< 130 mEq/L and 130–134 mEq/L). All-cause mortality was significantly different among the five groups (
p
= 0.025). Multivariate analysis indicated that all-cause mortality was significantly higher in the group with the lowest sodium level compared to the group with a serum sodium level of 135–139 mEq/L (hazard ratio: 1.61, 95% confidence interval: 1.04–2.49).
Conclusion
Hyponatremia of < 130 mEq/L at dialysis initiation was significantly associated with all-cause mortality. We considered the results relevant to underlying conditions, including cardiovascular disease and medications.</description><subject>Body weight</subject><subject>Cardiovascular diseases</subject><subject>Dialysis</subject><subject>Diuretics</subject><subject>Hemodialysis</subject><subject>Hyponatremia</subject><subject>Kidney diseases</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Mortality</subject><subject>Multivariate analysis</subject><subject>Nephrology</subject><subject>Original Article</subject><subject>Sodium</subject><subject>Ultrafiltration</subject><subject>Urology</subject><issn>1342-1751</issn><issn>1437-7799</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kE1rFTEUhoMo9kP_gAsJuOlm6knOJJksS2m1UBBE3YZM5lxNyczcJjMt99-b9lYLLlyEE8jzvic8jL0TcCoAzMciQCjTgMSHo7GxL9ihaNE0xlj7st6xlY0wShywo1JuAKCzyr5mB2ikbmWHh-zHV0p-ifNUfsUt72m5J5p4obyOvMxDrCPRHSXuFz5En3YlFh6nuMTHFPfTwH1KTfBrIT7OefEpLrs37NXGp0Jvn-Yx-3558e38c3P95dPV-dl1E1DB0lC7Ma32_YAglaBgUYceTAtKedmRBtho3ak26NCZDvvBCivQ2EA9YOgVHrOTfe82z7crlcWNsQRKyU80r8XJTkqsK4Sp6Id_0Jt5zVP9XaUsIHZK6UrJPRXyXEqmjdvmOPq8cwLcg3W3t-6qcfdo3dkaev9UvfYjDX8jfzRXAPdAqU_TT8rPu_9T-xuOGYyo</recordid><startdate>20230901</startdate><enddate>20230901</enddate><creator>Sasakawa, Yuji</creator><creator>Tatematsu, Yoshitaka</creator><creator>Kato, Joichiro</creator><creator>Fujii, Maya</creator><creator>Okamoto, Naoki</creator><creator>Inaguma, Daijo</creator><general>Springer Nature Singapore</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-3977-5933</orcidid></search><sort><creationdate>20230901</creationdate><title>Relationship between serum sodium level at dialysis initiation and all-cause mortality</title><author>Sasakawa, Yuji ; Tatematsu, Yoshitaka ; Kato, Joichiro ; Fujii, Maya ; Okamoto, Naoki ; Inaguma, Daijo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c350t-e4f746abd30251ec936cb074055a28e600f66854c6c8783bd9191379ceb03cb53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Body weight</topic><topic>Cardiovascular diseases</topic><topic>Dialysis</topic><topic>Diuretics</topic><topic>Hemodialysis</topic><topic>Hyponatremia</topic><topic>Kidney diseases</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Mortality</topic><topic>Multivariate analysis</topic><topic>Nephrology</topic><topic>Original Article</topic><topic>Sodium</topic><topic>Ultrafiltration</topic><topic>Urology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sasakawa, Yuji</creatorcontrib><creatorcontrib>Tatematsu, Yoshitaka</creatorcontrib><creatorcontrib>Kato, Joichiro</creatorcontrib><creatorcontrib>Fujii, Maya</creatorcontrib><creatorcontrib>Okamoto, Naoki</creatorcontrib><creatorcontrib>Inaguma, Daijo</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical and experimental nephrology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sasakawa, Yuji</au><au>Tatematsu, Yoshitaka</au><au>Kato, Joichiro</au><au>Fujii, Maya</au><au>Okamoto, Naoki</au><au>Inaguma, Daijo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Relationship between serum sodium level at dialysis initiation and all-cause mortality</atitle><jtitle>Clinical and experimental nephrology</jtitle><stitle>Clin Exp Nephrol</stitle><addtitle>Clin Exp Nephrol</addtitle><date>2023-09-01</date><risdate>2023</risdate><volume>27</volume><issue>9</issue><spage>747</spage><epage>756</epage><pages>747-756</pages><issn>1342-1751</issn><eissn>1437-7799</eissn><abstract>Background
Hyponatremia is a common electrolyte disorder in patients with chronic kidney disease. In addition, hyponatremia is associated with mortality in patients with chronic kidney disease, including those on dialysis. However, few studies have examined this relationship in patients with incident dialysis.
Methods
We used a database of multicenter prospective cohort studies that included 1520 incident dialysis patients. The baseline was set at the time of dialysis initiation. The enrolled patients were classified into five groups according to their serum sodium levels (< 130 mEq/L, 130–134 mEq/L, 135–139 mEq/L, 140–144 mEq/L, and ≥ 145 mEq/L). Multivariate Cox proportional hazards analysis was conducted to determine factors associated with all-cause mortality.
Results
A total of 392 all-cause deaths occurred during the follow-up period. The ultrafiltration volume per body weight during the first dialysis session was more significant in the groups with the lowest and highest sodium levels. The percentage of patients using loop diuretics and thiazide was higher in the group with lower sodium levels (< 130 mEq/L and 130–134 mEq/L). All-cause mortality was significantly different among the five groups (
p
= 0.025). Multivariate analysis indicated that all-cause mortality was significantly higher in the group with the lowest sodium level compared to the group with a serum sodium level of 135–139 mEq/L (hazard ratio: 1.61, 95% confidence interval: 1.04–2.49).
Conclusion
Hyponatremia of < 130 mEq/L at dialysis initiation was significantly associated with all-cause mortality. We considered the results relevant to underlying conditions, including cardiovascular disease and medications.</abstract><cop>Singapore</cop><pub>Springer Nature Singapore</pub><pmid>37264283</pmid><doi>10.1007/s10157-023-02363-9</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-3977-5933</orcidid></addata></record> |
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| ispartof | Clinical and experimental nephrology, 2023-09, Vol.27 (9), p.747-756 |
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| subjects | Body weight Cardiovascular diseases Dialysis Diuretics Hemodialysis Hyponatremia Kidney diseases Medicine Medicine & Public Health Mortality Multivariate analysis Nephrology Original Article Sodium Ultrafiltration Urology |
| title | Relationship between serum sodium level at dialysis initiation and all-cause mortality |
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