Early nephologist referral for patients with hyponatremia may reduce hospital stays, death
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Key takeaways:
- Patients referred within the first day of admission had a median 8.41-day hospital stay.
- Patients referred after a week had a median 24.57-day admission.
SAN DIEGO — Earlier referral to a nephologist for patients with a hyponatremia electrolyte abnormality may be linked to shorter hospital stays and lower mortality rates, data show.
Researchers in the retrospective study were “curious about whether the timing of referral to nephrology protocol management of hyponatremia would affect the outcomes of inpatients,” Charles Michael Herrera, MD, of Philippine General Hospital, told Healio.
Herrera and colleagues ran a 6-month cohort trial at a tertiary hospital that included 800 patients with hyponatremia to evaluate the impact of referral times on length of stay, in-hospital mortality and hyponatremia. Data were presented at ASN Kidney Week.
Overall morality was 31.87%, according to Herrera. Patients referred within the first day of admission had a median 8.41-day hospital stay vs. 24.57 days for those referred after a week. Early referrals were associated with a 26.04% mortality rate vs. 51.35% for those referred at 1 week (HR = 2.91; 95% CI, 1.94-4.36). Patients referred between 3 to 7 days had higher mortality risk than those referred within the first day, the researchers found.
Based on Kaplan-Meier survival curves, there was a survival decline for patients who were referred more than 72 hours after admission.
There was no group difference in reaching normal sodium levels before discharge or mortality, according to Herrera.
Overall, the information “seems to suggest an association between early referral and shorter hospital stay, lower mortality,” Herrera said. “Further studies looking specifically into the types of treatments that they gave these patients ... [and] these mild moderates and irrigation were treated, and what kind of therapies were in between,” may be beneficial.
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Herrera CM, et al. TH-PO327. Presented at: ASN Kidney Week; Oct. 24-27, 2024; San Diego.
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