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Associations of dysnatremias with mortality in chronic kidney disease

Haiquan Huang1,2, Stacey E Jolly3, Medha Airy4

  • 1Department of Nephrology and Hypertension, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA.

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
|May 26, 2016
PubMed

Insights

In patients with chronic kidney disease (CKD), both low (hyponatremia) and high (hypernatremia) serum sodium levels increase mortality risk. Hyponatremia is linked to cardiovascular, malignancy, and other deaths, while hypernatremia is associated with non-cardiovascular/non-malignancy deaths.

Area of Science:

  • Nephrology
  • Internal Medicine
  • Clinical Research

Background:

  • Hyponatremia and hypernatremia are linked to increased mortality in the general population and patients with chronic kidney disease (CKD).
  • Understanding the specific mortality risks associated with dysnatremias in CKD patients is crucial for clinical management.

Purpose of the Study:

  • To investigate the associations between hyponatremia and hypernatremia and all-cause mortality in patients with Stage 3 and 4 CKD.
  • To examine the relationships between dysnatremias and specific causes of death, including cardiovascular, malignancy-related, and other causes.

Main Methods:

  • A large cohort of 45,333 patients with Stage 3 and 4 CKD was analyzed.
  • Cox proportional hazards and competing risk models were employed to assess the associations between serum sodium levels (hyponatremia <136 mmol/L, hypernatremia >145 mmol/L) and mortality outcomes.

Main Results:

  • Dysnatremias were present in 9.2% of the study cohort.
  • Both hyponatremia and hypernatremia were independently associated with all-cause mortality.
  • Hyponatremia increased the risk of cardiovascular, malignancy-related, and non-cardiovascular/non-malignancy deaths.
  • Hypernatremia was significantly associated with an increased risk of non-cardiovascular/non-malignancy deaths.

Conclusions:

  • In CKD patients, hyponatremia is associated with increased all-cause mortality and specific causes of death (cardiovascular, malignancy, other).
  • Hypernatremia in CKD patients is linked to increased all-cause and non-cardiovascular/non-malignancy mortality.
  • Further research is needed to understand the underlying mechanisms driving these cause-specific mortality differences in dysnatremias among CKD patients.
Abstract

Keywords:
mortality and chronic kidney diseasesodium

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