Increased Serum Sodium at Acute Kidney Injury Onset Predicts In-Hospital Death.

Autor:	Marahrens B; Innere Medizin 1, Kardiologie, Angiologie, Nephrologie, Universitatsklinikum Brandenburg, Medizinische Hochschule Brandenburg, Brandenburg, Germany.; These authors contributed equally to the study., Damsch L; Innere Medizin 1, Kardiologie, Angiologie, Nephrologie, Universitatsklinikum Brandenburg, Medizinische Hochschule Brandenburg, Brandenburg, Germany.; These authors contributed equally to the study., Lehmann R; Innere Medizin 1, Kardiologie, Angiologie, Nephrologie, Universitatsklinikum Brandenburg, Medizinische Hochschule Brandenburg, Brandenburg, Germany., Matyukhin I; Innere Medizin 1, Kardiologie, Angiologie, Nephrologie, Universitatsklinikum Brandenburg, Medizinische Hochschule Brandenburg, Brandenburg, Germany., Patschan S; Innere Medizin 1, Kardiologie, Angiologie, Nephrologie, Universitatsklinikum Brandenburg, Medizinische Hochschule Brandenburg, Brandenburg, Germany., Patschan D; Innere Medizin 1, Kardiologie, Angiologie, Nephrologie, Universitatsklinikum Brandenburg, Medizinische Hochschule Brandenburg, Brandenburg, Germany.
Jazyk:	angličtina
Zdroj:	Journal of clinical medicine research [J Clin Med Res] 2023 Feb; Vol. 15 (2), pp. 90-98. Date of Electronic Publication: 2023 Feb 28.
DOI:	10.14740/jocmr4845
Abstrakt:	Background: Over the last decades, acute kidney injury (AKI) has been identified as a potentially fatal diagnosis which substantially increases in-hospital mortality in the short term and morbidity/mortality in the long term. However, reliable biomarkers for predicting AKI-associated outcomes are still missing. In this study, we assessed whether serum sodium, measured at different time points during the in-hospital treatment period, provided prognostic information in AKI. Methods: This was a retrospective, observational cohort study. AKI subjects were identified via the in-hospital AKI alert system. Serum sodium and potassium levels were documented at five pre-defined time points: hospital admission, AKI onset, minimum estimated glomerular filtration rate, minimum and maximum of the respective electrolyte during the treatment period. In-hospital death, the need for kidney replacement therapy (KRT) and recovery of kidney function were defined as endpoints. Results: Patients who suffered in-hospital death (n = 37, 23.1%) showed significantly higher serum sodium levels at diagnosis of AKI (survivors: 145.7 ± 2.13 vs. non-survivors: 138.8 ± 0.636 mmol/L, P = 0.003). A logistic regression model was significant for serum sodium levels in patients with in-hospital death (X 2 , P = 0.003; odds ratio = 1.08 (1.022 - 1.141); R 2 = 0.082; d = 0.089). This suggests an increase of the relative risk for in-hospital death by 8% with every unit of serum sodium increase. Patients with a sodium above the upper normal range at AKI diagnosis were also more likely to suffer in-hospital death (P = 0.001). Conclusion: In summary, we present evidence that serum sodium, measured at time of AKI diagnosis, potentially serves as a predictor for in-hospital death in patients with AKI. Competing Interests: The authors declare that they have no conflict of interest. (Copyright 2023, Marahrens et al.)
Databáze:	MEDLINE
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