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Published on: July 17, 2016
Hyponatremia, acute kidney injury, and mortality in HIV-related toxoplasmic encephalitis
Alexandre B Libório1, Geraldo B Silva, Carolina G C H Silva
1School of Medicine, Health Sciences Center, Universidade de Fortaleza, Fortaleza, CE, Brazil.
Background:
There are no reports on hyponatremia and acute kidney injury (AKI) involved in the course of HIV-related toxoplasmic encephalitis (TE). The main objective of this study was to describe the occurrence of hyponatremia and its relationship with AKI and mortality in HIV-related toxoplasmic encephalitis (TE).
Methods:
This was a retrospective cohort study on patients with HIV-related TE. AKI was considered only when the RIFLE (risk, injury, failure, loss, end-stage) criterion was met, after the patient was admitted.
Results:
A total of 92 patients were included, with a mean age of 36±9 years. Hyponatremia at admission was observed in 43 patients (46.7%), with AKI developing in 25 (27.1%) patients during their hospitalization. Sulfadiazine was the treatment of choice in 81% of the cases. Death occurred in 13 cases (14.1%). Low serum sodium level correlated directly with AKI and mortality. Male gender (OR 7.89, 95% CI 1.22-50.90, p = 0.03) and hyponatremia at admission (OR 4.73, 95% CI 1.22-18.30, p = 0.02) were predictors for AKI. Independent risk factors for death were AKI (OR 8.3, 95% CI 1.4-48.2, p < 0.0001) and hyponatremia (OR 9.9, 95% CI 1.2-96.3, p < 0.0001).
Conclusion:
AKI and hyponatremia are frequent in TE. Hyponatremia on admission is highly associated with AKI and mortality.
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