Sodium and Hematocrit Levels' Correlation and Clinical Impacts in Jordanian Hemodialysis Patients

Given cofounders, this retrospective study investigates the correlation between hyponatremia status and hematocrit (Hct) changes, as well as the clinical utility of these two prognosticators in relation to overall health status.

The study was retrospectively conducted on adult hemodialysis (HD) patients at the King Hussein Medical Center in Amman, Jordan, from 2015 to 2022. It looked at how sodium (Na) levels, the hematocrit-to-hemoglobin ratio (HHR), and outcomes of interest were related. The study examined acute myocardial infarction, stroke, refractory hypertension, dialysis graft thrombosis, and all-cause mortality as the composite outcomes of interest (cOI). We conducted a series of receiver operating characteristics, binary logistic regression (BLgR), and sensitivity analyses between each tested prognosticator and the cOI. We constructed and illustrated a multiple logistic regression (MLgR) model to investigate the adjusted association of each prognosticator against the tested composite outcome probability.

The majority of HD patients were hemolyzed for a period of four to seven years. The constructed binary regression modeling for each prognosticator was [e (109.36 - 0.849 × Na)/[1 + e (109.36 - 0.849 × Na)] and [e (16.033 - 6.388 × HHR)/[1 + e (16.033 - 6.388 ×HHR)], with a 35.57% probability of cOI at the optimal Na of 129.51 mEq/l and a 42.8% at optimal HHR of 2.555:1. When the length of hemodialysis (LOD) was introduced into the MLgR modeling all the investigated independent variables were significant except the HHR (p-value = 0.908).

A higher LOD, lower Na, and lower HHR all support a positive cOI probability status. Regular inspection of Na and HHR and ensuring their closet to their optimal thresholds are mandatory to mitigate the risk of higher cOI probability.