Association of serum sodium levels with fractures and mortality in patients undergoing maintenance hemodialysis.

Autor: Soeda K; Division of Nephrology, Endocrinology and Metabolism, Tokai University School of Medicine, 143 Shimo-Kasuya, Isehara, 259-1193, Japan., Komaba H; Division of Nephrology, Endocrinology and Metabolism, Tokai University School of Medicine, 143 Shimo-Kasuya, Isehara, 259-1193, Japan. hkomaba@tokai-u.jp.; The Institute of Medical Sciences, Tokai University, Isehara, Japan. hkomaba@tokai-u.jp., Nakagawa Y; Division of Nephrology, Endocrinology and Metabolism, Tokai University School of Medicine, 143 Shimo-Kasuya, Isehara, 259-1193, Japan., Kawabata C; Division of Nephrology, Endocrinology and Metabolism, Tokai University School of Medicine, 143 Shimo-Kasuya, Isehara, 259-1193, Japan.; Division of Nephrology and Endocrinology, The University of Tokyo Graduate School of Medicine, Tokyo, Japan., Wada T; Division of Nephrology, Endocrinology and Metabolism, Tokai University School of Medicine, 143 Shimo-Kasuya, Isehara, 259-1193, Japan.; Department of Nephrology, Toranomon Hospital, Tokyo, Japan., Takahashi H; Division of Nephrology and Diabetes, Tokai University Oiso Hospital, Oiso, Japan.; Jinken Clinic, Ebina, Japan., Takahashi Y; Jinken Clinic, Ebina, Japan., Hyodo T; Medical Corporation Kuratakai, Hiratsuka, Japan., Hida M; Medical Corporation Kuratakai, Hiratsuka, Japan., Suga T; Medical Corporation Showakai, Tokyo, Japan., Kakuta T; Division of Nephrology, Endocrinology and Metabolism, Tokai University Hachioji Hospital, Hachioji, Japan., Fukagawa M; Division of Nephrology, Endocrinology and Metabolism, Tokai University School of Medicine, 143 Shimo-Kasuya, Isehara, 259-1193, Japan.
Jazyk: angličtina
Zdroj: Journal of nephrology [J Nephrol] 2024 Jun; Vol. 37 (5), pp. 1339-1349. Date of Electronic Publication: 2024 Mar 21.
DOI: 10.1007/s40620-024-01904-z
Abstrakt: Background: Hyponatremia is implicated in pathological bone resorption and has been identified as a risk factor for bone fracture in the general population. However, there are limited data on the association between serum sodium levels and fracture risk in patients undergoing hemodialysis (HD).
Methods: We analyzed a historical cohort of 2220 maintenance HD patients to examine the association between serum sodium levels and the risk of fracture and mortality. We also examined the association between serum sodium levels and osteoporosis, based on metacarpal bone mineral density, in a subcohort of 455 patients with available data. In addition, we examined the association between serum sodium levels and bone turnover markers in a separate cross-sectional cohort of 654 maintenance HD patients.
Results: During a median follow-up of 5.4 years, 712 patients died, 113 experienced clinical fractures, and 64 experienced asymptomatic vertebral fractures. Lower serum sodium levels were associated with an increased risk of mortality (HR 1.06 per 1 mEq/L decrease; 95% CI 1.03-1.09) but not with the risk of clinical fracture (HR 1.04 per 1 mEq/L decrease; 95% CI 0.97-1.11). A similar lack of association was observed for asymptomatic vertebral fracture and any fracture. Serum sodium levels were also not associated with osteoporosis in a subcohort with available data (n = 455) or with bone alkaline phosphatase or tartrate-resistant acid phosphatase-5b in a separate cross-sectional cohort.
Conclusion: Serum sodium levels were associated with mortality but not with fracture risk, osteoporosis, or bone turnover markers in maintenance HD patients.
(© 2024. The Author(s) under exclusive licence to Italian Society of Nephrology.)
Databáze: MEDLINE
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