ArticleKidney international reports2021
Pre-dialysis Hyponatremia and Change in Serum Sodium Concentration During a Dialysis Session Are Significant Predictors of Mortality in Patients Undergoing Hemodialysis.
Article in Kidney international reports, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 33 citations in OpenAlex.
- Review
- Changes in serum sodium concentration during hemodialysis is a predictor of mortality and cardio-cerebrovascular event.Renal failure · 2024Article
- Technical requirements and devices available for long-term hemodialysis in children-mind the gap!Pediatric nephrology (Berlin, Germany) · 2024Review
- Association of serum sodium levels with fractures and mortality in patients undergoing maintenance hemodialysis.Journal of nephrology · 2024Article
- Practical implementation and clinical benefits of the new automated dialysate sodium control biosensor.Clinical kidney journal · 2023Article
- The impact of chronic pre-dialysis hyponatremia on clinical outcomes in maintenance hemodialysis patients.International urology and nephrology · 2022Article
- Fluid Overload and Tissue Sodium Accumulation as Main Drivers of Protein Energy Malnutrition in Dialysis Patients.Nutrients · 2022Review
- Clinical epidemiological analysis of cohort studies investigating the pathogenesis of kidney disease.Clinical and experimental nephrology · 2022Review
- 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
- Predialysis Hyponatremia and Positive Change of Natremia Within Hemodialysis Sessions Are Strong Indicators of Poor Cardiovascular Outcome in Hemodialysis Patients.Kidney international reports · 2021Article
- Association between salt intake and long-term mortality in hemodialysis patients: A retrospective cohort study.PloS one · 2021Article
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Authors and funding
7 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPrevious studies have shown that hyponatremia is associated with greater mortality in hemodialysis (HD) patients. However, there have been few reports regarding the importance of the change in serum sodium (SNa) concentration (ΔSNa) during dialysis sessions. To investigate the relationships of pre-dialysis hyponatremia and ΔSNa during a dialysis session with mortality, we analyzed data from a national registry of Japanese patients with end-stage kidney disease.
methodsWe identified 178,114 patients in the database who were undergoing HD 3 times weekly. The study outcome was 2-year all-cause mortality, and the baseline SNa concentrations were categorized into quintiles. We evaluated the relationships of SNa concentration and ΔSNa with mortality using Cox proportional hazards models.
resultsDuring a 2-year follow-up period, 25,928 patients died. Each 1-mEq/l reduction in pre-HD SNa concentration was associated with a cumulatively greater risk of all-cause mortality (hazard ratio [HR], 1.05; 95% confidence interval [CI], 1.05-1.06). In contrast, a larger ΔSNa was associated with higher all-cause mortality (HR for a 1-mEq/l increase in ΔSNa, 1.02; 95% CI 1.01-1.02). The combination of low pre-HD SNa concentration and large ΔSNa was also associated with higher mortality (HR 1.09; 95% CI 1.05-1.13). Participants with the lowest SNa concentration (≤136 mEq/L) and the highest ΔSNa (>4 mEq/L) showed higher mortality than those with an intermediate pre-HD SNa concentration (137-140 mEq/L) and the lowest ΔSNa (≤2 mEq/L).
conclusionsLower pre-HD SNa concentration and higher ΔSNa are associated with a greater risk of mortality in patients undergoing HD.
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