ArticleThe Korean journal of internal medicine2018
Predialysis hyponatremia and mortality in elderly patients beginning to undergo hemodialysis.
Article in The Korean journal of internal medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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5 citing papers in PubMed, 7 citations in OpenAlex.
- Effects of high-sensitivity C-reactive protein and left ventricular hypertrophy on cognitive function in hemodialysis patients.Renal failure · 2025Article
- Evaluation and management of hypernatremia in adults: clinical perspectives.The Korean journal of internal medicine · 2023Review
- Sodium First Approach, to Reset Our Mind for Improving Management of Sodium, Water, Volume and Pressure in Hemodialysis Patients, and to Reduce Cardiovascular Burden and Improve Outcomes.Frontiers in nephrology · 2022Review
- Dysnatremias in Chronic Kidney Disease: Pathophysiology, Manifestations, and Treatment.Frontiers in medicine · 2021Review
- Anion gap predicts early mortality after starting hemodialysis in the elderly.Clinical and experimental nephrology · 2020Article
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Authors and funding
5 authors at 3 institutions in 1 country.
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Abstract
BACKGROUND/
aimsPredialysis hyponatremia has been recently reported to be associated with mortality in incident hemodialysis patients. However, whether hyponatremia is associated with unfavorable outcomes in elderly patients remains unknown. We hypothesized that nephrology referral inf luences hyponatremia, and aimed to define how nephrology referral affects the association between hyponatremia and mortality in the elderly.
methodsWe retrospectively assessed mortality in 599 incident hemodialysis patients aged ≥ 70 at a tertiary university hospital, between 2000 and 2010. We analyzed 90-day and 1-year all-cause mortality (ACM) in relation to predialysis serum sodium (sNa). We divided the patients into two groups according to predialysis glucose-corrected sNa: hyponatremia (< 135 mmol/L) and normonatremia (135 to 145 mmol/L).
resultsLow estimated glomerular filtration rate, high phosphorus, low albumin, nonpreparation of arteriovenous fistula or graft, and late referral were associated with a low sNa in the elderly. Among 599 patients, 106 and 174 patients died at the 90-day and 1-year follow-ups, respectively. Each 10-mmol/L increase in predialysis sNa tended to be associated with lower 90-day and 1-year ACM. When patients were stratified by nephrology referral, hyponatremia was associated with increased mortality in early referral group (90-day ACM: hazard ratio [HR] = 2.335, p = 0.041; 1-year ACM: HR = 1.790, p = 0.024). However, hyponatremia was not associated with mortality in late referral group.
conclusionPredialysis hyponatremia at hemodialysis initiation is associated with late referra.
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