ArticlePloS one2016
The Effects of Pre-Existing Hyponatremia and Subsequent-Developing Acute Kidney Injury on In-Hospital Mortality: A Retrospective Cohort Study.
Article in PloS one, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.
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Who cites it
22 citing papers in PubMed, 1 synthesis or guideline pooled it, 38 citations in OpenAlex.
- Acute Kidney Injury and Hyponatremia in Ultra-Trail Racing: A Systematic Review.Medicina (Kaunas, Lithuania) · 2022Pooled it
- Preoperative natremia and AKI after cardiac surgery: an international multicenter prospective cohort study.Journal of anesthesia, analgesia and critical care · 2026Article
- AKI Subtyping and Prognostic Analysis Based on Serum Electrolyte Features in ICU.Journal of clinical medicine · 2025Article
- Establishment and validation of a prediction model for acute kidney injury in moderate severe and severe acute pancreatitis patients.European journal of medical research · 2025Article
- Impact of hypotonic hyponatremia on outcomes in patients undergoing transcatheter aortic valve replacement: a national inpatient sample.BMC cardiovascular disorders · 2025Article
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- Automated machine learning for early prediction of acute kidney injury in acute pancreatitis.BMC medical informatics and decision making · 2024Article
- Commentary: Sodium levels and immunotherapy efficacy in mRCC patients with bone metastases: sub analysis of Meet-Uro 15 study.Frontiers in immunology · 2024Article
- Hypernatremia: Epidemiology and Predictive Role in Emerging and Established Acute Kidney Injury.Journal of clinical medicine research · 2023Review
- Short-term prognostic models for severe acute kidney injury patients receiving prolonged intermittent renal replacement therapy based on machine learning.BMC medical informatics and decision making · 2023Article
- Stratification of Acute Kidney Injury Risk, Disease Severity, and Outcomes by Electrolyte Disturbances.Journal of clinical medicine research · 2023Review
- Association of early hyponatremia and the development of acute kidney injury in critically ill children.Pediatric nephrology (Berlin, Germany) · 2022Article
- Association of early dysnatremia with mortality in the neonatal intensive care unit: results from the AWAKEN study.Journal of perinatology : official journal of the California Perinatal Association · 2022Article
- Nomogram Prediction Model of Serum Chloride and Sodium Ions on the Risk of Acute Kidney Injury in Critically Ill Patients.Infection and drug resistance · 2022Article
- Serum sodium variability and acute kidney injury: a retrospective observational cohort study on a hospitalized population.Internal and emergency medicine · 2021Observational
- Lower serum sodium levels predict poor clinical outcomes in patients with insomnia.BMC nephrology · 2020Article
- Simple Postoperative AKI Risk (SPARK) Classification before Noncardiac Surgery: A Prediction Index Development Study with External Validation.Journal of the American Society of Nephrology : JASN · 2019Observational
- Progressive kidney disease may not alter the association of hyponatremia with mortality.Clinical and experimental nephrology · 2018Article
- Could sodium imbalances predispose to postoperative venous thromboembolism? An analysis of the NSQIP database.Thrombosis journal · 2018Article
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
objectivesBoth hyponatremia and acute kidney injury (AKI) are common and harmful in hospitalized patients. However, their combined effects on patient mortality have been little studied.
methodsWe retrospectively enrolled 19191 adult patients who were admitted for 1 year. Pre-existing hyponatremia was defined as a serum sodium level < 135 mmol/L on the first measurement of their admission. AKI was defined as a rise in serum creatinine by ≥ 26.5 μmol/L or ≥ 1.5 times of the baseline value of creatinine during the hospital stay.
resultsThe prevalence of pre-existing hyponatremia was 8.2%. During a median 6.0 days of hospital stay, the incidence rates of AKI and in-hospital patient mortality were 5.1% and 0.9%, respectively. Pre-existing hyponatremia independently predicted AKI development and in-hospital mortality (adjusted hazard ratio [HR] 1.300, P = 0.004; HR 2.481, P = 0.002, respectively). Pre-existing hyponatremia and subsequent development of AKI increased in-hospital mortality by 85 times, compared to the patients with normonatremia and no AKI. In subgroup analysis, the AKI group showed higher rates of de novo hypernatremia than the non-AKI group during the admission. De novo hypernatremia, which might be associated with over-correction of hyponatremia, increased in-hospital mortality (HR 3.297, P <0.001), and patients with AKI showed significantly higher rates of de novo hypernatremia than patients without AKI (16.2% vs. 1.4%, P < 0.001, respectively).
conclusionPre-existing hyponatremia may be associated with the development of AKI in hospitalized patients, and both hyponatremia and hospital-acquired AKI could have a detrimental effect on short term patient mortality, which might be related to the inappropriate correction of hyponatremia in AKI patients.
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