Time-dependent dysnatremias correlated with mortality in patients with CKD
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Time-dependent dysnatremias was significantly associated with mortality among patients with chronic kidney disease, according to data published in Kidney Medicine.
Further, dysnatremias correlated with an increased risk for kidney failure.
“Dysnatremias in patients with CKD have been associated with increased all-cause mortality, cardiovascular, malignancy and non-cardiovascular/non-malignancy-related deaths,” Mohamed Hassanein, MD, from the University of Mississippi Medical Center, and colleagues wrote. They added, “There is a void of literature on the long-term effects of sodium in an extensively studied CKD population, and therefore, we sought to evaluate the effect of dysnatremias on mortality and kidney failure from patients enrolled in the Chronic Renal Insufficiency Cohort (CRIC) study.”
In an analysis of a prospective cohort study, researchers examined 5,444 adult patients with CKD from CRIC to determine the prevalence of and risk factors related to dysnatremias.
With all-cause mortality and kidney failure serving as the primary outcomes, researchers considered baseline and time-dependent hyponatremia and hypernatremia the predictors.
Using 2 tests for categorical variables, analysis of variance for age and Kruskal Wallis tests for laboratory, researchers compared baseline characteristics. Additionally, researchers performed Cox proportional hazards models and competing risk models to identify the relationship between baseline sodium level and overall mortality.
Among the participants, 9% had hyponatremia and 1% had hypernatremia. During the study period, a total of 1,508 patients died and 1,206 experienced kidney failure. Analyses revealed time-dependent dysnatremias were associated with mortality for both hyponatremia and hypernatremia. Although time-dependent hypernatremia correlated with an increased risk of kidney disease regardless of age, baseline and time-dependent hyponatremia was associated with an increased risk in patients younger than 65 years old but not older.
Researchers identified female sex, diabetes and hypertension as factors correlated with hyponatremia.
“In summary, our results suggest an increased risk of mortality and progression to kidney failure in patients with baseline hyponatremia who are younger than 65 years,” Hassanein and colleagues wrote. They added, “Treating physicians should recognize the potential risks of dysnatremias in patients with CKD in the hopes of potentially improving outcomes. More clarity is required to better understand the association between dysnatremias, mortality and kidney failure, and if correction can improve outcomes.”
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