Hyponatremia in Peritoneal Dialysis: Epidemiology in a Single Center and Correlation with Clinical and Biochemical Parameters
Notice bibliographique
Résumé
BACKGROUND: Hyponatremia in peritoneal dialysis (PD) patients has previously been associated with water overload and weight gain, or with malnutrition and intracellular potassium depletion. Although there is a sizable literature about transmembrane sodium and water removal in PD, there are few reports about the incidence and characteristics of hyponatremia in the clinical setting. AIM: We evaluated the incidence and factors associated with hyponatremia in PD patients in a single PD unit. METHODS: We retrospectively evaluated the records of all patients (n = 198) who were treated with PD in the Home PD Unit of the University Health Network at Toronto General Hospital during 2010. We identified 166 patients who had a minimum follow-up of 60 days during 2010 and at least 2 consecutive sodium measurements at least a month apart. We examined baseline differences between patients who developed hyponatremia and those who did not, and clinical and biochemical factors that correlated with mean sodium values. In the 24 patients who developed hyponatremia, we examined paired differences between the normonatremic and hyponatremic periods. Finally, we investigated any possible correlations of change in serum sodium with clinical and biochemical characteristics before and during the hyponatremic period. RESULTS: The incidence of hyponatremia was 14.5%. In multivariate analysis, serum sodium correlated significantly and independently with residual renal function (RRF: r = 0.463, p = 0.0001) and negatively with the daily volume of instilled icodextrin (r = -0.476, p = 0.0001). Residual renal function was significantly lower in patients with hyponatremia than in those with normal serum sodium (1.97 ± 2.3 mL/min vs 4.31 ± 5.01 mL/min, p = 0.033). The mean paired difference in body weight was -1.113 kg and the median difference was -0.55 kg (range: -8.5 kg to +4.2 kg). Impressively, hyponatremia was not associated with an increase in body weight in most patients who developed this complication (13 of 16 for whom comparative weights were known). Moreover, the mean paired change in serum sodium (ΔNa) from normonatremia to hyponatremia was, contrary to our expectations, significantly correlated with a decrease in body weight (r = 0.584, p = 0.017). The ΔNa was also significantly correlated with serum potassium (r = 0.526, p = 0.008), the greatest drop in serum sodium being associated with lower serum potassium in the hyponatremic period, as predicted. CONCLUSIONS: Hyponatremia is seen more often than expected in a clinical setting. Serum sodium is strongly correlated with RRF, hyponatremia being associated with lower RRF. In patients who experienced hyponatremia, the fall in serum sodium was associated with a decrease, not an increase, in body weight and was correlated with serum potassium, suggesting that sodium and potassium depletion-and, by inference, malnutrition-may be important contributors in the clinical setting.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».