ArticleNephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association2020
Increased mortality risk associated with serum sodium variations and borderline hypo- and hypernatremia in hospitalized adults.
Article in Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers.
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Who cites it
27 citing papers in PubMed, 49 citations in OpenAlex.
- Multiple electrolyte imbalances in hospitalized patients: a multimorbidity perspective from a large, retrospective cohort study.Annals of medicine · 2026Article
- Sodium load of novel antibiotics: considerations for nephrologists and clinicians.International urology and nephrology · 2026Review
- Dynamic variability of serum sodium, potassium, and calcium and mortality after acute myocardial infarction: insights from traditional and machine learning approaches.BMC cardiovascular disorders · 2026Article
- Association between serum sodium trajectories and all-cause mortality in critically ill patients with ischemic stroke: a retrospective analysis of the MIMIC-IV database.European journal of medical research · 2025Article
- Multiparametric Evaluation of Drug-Induced Acute Kidney Injury Using Preclinical 7T Magnetic Resonance Imaging in Rat Models.Metabolites · 2025Article
- Prevalence of Hypernatremia Among Medically Hospitalized Patients and the Related Clinical Outcomes.Oman medical journal · 2025Article
- Relationship between Rate of Hypernatremia Correction and Outcomes in Hospitalized Patients.Kidney360 · 2025Article
- The risk of sodium overcorrections in severe hyponatremia and the utility of desmopressin: a large retrospective study.Clinical kidney journal · 2025Article
- Associations between serum sodium level ranges with geriatric syndromes.European geriatric medicine · 2025Article
- Effect of long-term serum sodium levels on the prognosis of patients on maintenance hemodialysis.Renal failure · 2024Article
- Association between serum sodium trajectory and mortality in patients with acute kidney injury: a retrospective cohort study.BMC nephrology · 2024Article
- CARDS, a Novel Prognostic Index for Risk Stratification and In-Hospital Monitoring.Journal of clinical medicine · 2024Article
- Observational
- Sodium fluctuation as a parameter in predicting mortality in general hospitalized patients.Frontiers in medicine · 2024Article
- Thalamic Neuron Resilience during Osmotic Demyelination Syndrome (ODS) Is Revealed by Primary Cilium Outgrowth and ADP-ribosylation factor-like protein 13B Labeling in Axon Initial Segment.International journal of molecular sciences · 2023Article
- Association between serum sodium level trajectories and survival in patients with heart failure.ESC heart failure · 2023Article
- Relationship between serum sodium level and sepsis-induced coagulopathy.Frontiers in medicine · 2023Article
- Hypernatremia subgroups among hospitalized patients by machine learning consensus clustering with different patient survival.Journal of nephrology · 2022Article
- Dysnatremia is associated with increased risk of all-cause mortality within 365 days post-discharge in patients with atrial fibrillation without heart failure: A prospective cohort study.Frontiers in cardiovascular medicine · 2022Article
- Association between serum sodium and in-hospital mortality among critically ill patients with spontaneous subarachnoid hemorrhage.Frontiers in neurology · 2022Article
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThis study aimed to evaluate short-term and long-term mortalities in a cohort of unselected hospitalized patients with serum sodium concentration ([Na+]) variations within and outside of reference range.
methodsAll adult patients admitted to the Mayo Clinic, Rochester, MN, USA from January 2011 to December 2013 (n = 147358) were retrospectively screened. Unique patients admitted during the study period were examined. The main exposure was serum [Na+] variation. Outcome measures were hospital and 1-year all-cause mortalities.
resultsA total of 60944 patients, mean age 63 ± 17 years, were studied. On admission, 17% (n = 10066) and 1.4% (n = 852) had hypo- and hypernatremia, respectively. During the hospital stay, 11044 and 4128 developed hypo- and hypernatremia, respectively, accounting for 52.3 and 82.9% of the total hypo- and hypernatremic patients. Serum [Na+] variations of ≥6 mEq/L occurred in 40.6% (n = 24 740) of the 60 944 patients and were significantly associated with hospital and 1-year mortalities after adjusting potential confounders (including demographics, comorbidities, estimated glomerular filtration rate, admission serum [Na+], number of [Na+] measurements and length of hospital stay). Adjusted odds ratios for hospital and 1-year mortalities increased with increasing [Na+] variations in a dose-dependent manner, from 1.47 to 5.48 (all 95% confidence intervals >1.0). Moreover, in fully adjusted models, [Na+] variations (≥6 mEq/L) within the reference range (135-145 mEq/L) or borderline hypo- or hypernatremia (133-137 and 143-147 mEq/L, respectively) compared with 138-142 mEq/L were associated with increased hospital and 1-year mortalities.
conclusionIn hospitalized adults, [Na+] fluctuation (≥6 mEq/L) irrespective of admission [Na+] and borderline hypo- or hypernatremia are independent predictors of progressively increasing short- and long-term mortality burdens.
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