Abnormal sodium levels at hospital discharge linked to higher risk of death


Hospitalized patients whose serum sodium levels fall outside the optimal range when they are discharged have an increased risk of dying within a year, investigators reported at the Kidney Week 2020 reimagined virtual conference. ‘American Society of Nephrology.

Between dysnatremias, hypernatremia at hospital discharge had a greater influence on 1-year mortality than discharge hyponatremia.

In a single-center study of 59,901 hospitalized patients, a team led by Charat Thongprayoon, MD, of the Mayo Clinic in Rochester, Minnesota, found that 1-year mortality rates were 26.1%, 15.5%, 11.6%, 17.2% and 49.4% for patients with serum sodium values ​​of 132 or less, 133-137, 138-142, 143-147 and 148 mEq/L or more, respectively.


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Compared to a baseline value of 138-142 mEq/L, those with values ​​of 132 or less, 133-137, 143-147 and 148 mEq/L or more had a significantly increased probability of mortality at 1 year by a factor of 1.43, 1.10, 1.35 and 3.86 (all P values ​​less than or equal to 0.001), respectively, after adjusting for age, sex, race, serum sodium values ​​at admission, Charlson comorbidity score and other potential confounders, depending on the investigators.

“The optimal serum sodium range at discharge from hospital was 138 to 142 mEq/L, but nearly half of hospitalized patients were discharged with serum sodium outside of this optimal range,” Dr. Thongprayoon said. . Kidney and Urology News. “Targeting serum sodium in the optimal range prior to hospital discharge may potentially lead to more favorable long-term survival.”

The study population was 54% male and 93% white. Discharge serum sodium values ​​were last measured within 48 hours prior to discharge.

Reference

Thongprayoon C, Cheungpasitporn W, Chewcharat A, et al. The prognostic importance of serum sodium levels at hospital discharge and 1-year mortality in hospitalized patients. Presented at the virtual Kidney Week 2020 Reimagined conference. Shows PO1437.

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