Moderate hyponatremia is associated with increased risk of mortality: evidence from a meta-analysis.

<h4>Background</h4>Hyponatremia is the most common electrolyte disorder in clinical practice, and evidence to date indicates that severe hyponatremia is associated with increased morbidity and mortality. The aim of our study was to perform a meta-analysis that included the published stud...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Giovanni Corona, Corinna Giuliani, Gabriele Parenti, Dario Norello, Joseph G Verbalis, Gianni Forti, Mario Maggi, Alessandro Peri
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2013
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/efff7920f6ba496484402c2a6617e9b9
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:efff7920f6ba496484402c2a6617e9b9
record_format	dspace
spelling	oai:doaj.org-article:efff7920f6ba496484402c2a6617e9b92021-11-18T08:41:29ZModerate hyponatremia is associated with increased risk of mortality: evidence from a meta-analysis.1932-620310.1371/journal.pone.0080451https://doaj.org/article/efff7920f6ba496484402c2a6617e9b92013-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24367479/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Hyponatremia is the most common electrolyte disorder in clinical practice, and evidence to date indicates that severe hyponatremia is associated with increased morbidity and mortality. The aim of our study was to perform a meta-analysis that included the published studies that compared mortality rates in subjects with or without hyponatremia of any degree.<h4>Methods and findings</h4>An extensive Medline, Embase and Cochrane search was performed to retrieve the studies published up to October 1st 2012, using the following words: "hyponatremia" and "mortality". Eighty-one studies satisfied inclusion criteria encompassing a total of 850222 patients, of whom 17.4% were hyponatremic. The identification of relevant abstracts, the selection of studies and the subsequent data extraction were performed independently by two of the authors, and conflicts resolved by a third investigator. Across all 81 studies, hyponatremia was significantly associated with an increased risk of overall mortality (RR = 2.60[2.31-2.93]). Hyponatremia was also associated with an increased risk of mortality in patients with myocardial infarction (RR = 2.83[2.23-3.58]), heart failure (RR = 2.47[2.09-2.92]), cirrhosis (RR = 3.34[1.91-5.83]), pulmonary infections (RR = 2.49[1.44-4.30]), mixed diseases (RR = 2.59[1.97-3.40]), and in hospitalized patients (RR = 2.48[2.09-2.95]). A mean difference of serum [Na(+)] of 4.8 mmol/L was found in subjects who died compared to survivors (130.1 ± 5.6 vs 134.9 ± 5.1 mmol/L). A meta-regression analysis showed that the hyponatremia-related risk of overall mortality was inversely correlated with serum [Na(+)]. This association was confirmed in a multiple regression model after adjusting for age, gender, and diabetes mellitus as an associated morbidity.<h4>Conclusions</h4>This meta-analysis shows for the first time that even a moderate serum [Na(+)] decrease is associated with an increased risk of mortality in commonly observed clinical conditions across large numbers of patients.Giovanni CoronaCorinna GiulianiGabriele ParentiDario NorelloJoseph G VerbalisGianni FortiMario MaggiAlessandro PeriPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 8, Iss 12, p e80451 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Giovanni Corona Corinna Giuliani Gabriele Parenti Dario Norello Joseph G Verbalis Gianni Forti Mario Maggi Alessandro Peri Moderate hyponatremia is associated with increased risk of mortality: evidence from a meta-analysis.
description	<h4>Background</h4>Hyponatremia is the most common electrolyte disorder in clinical practice, and evidence to date indicates that severe hyponatremia is associated with increased morbidity and mortality. The aim of our study was to perform a meta-analysis that included the published studies that compared mortality rates in subjects with or without hyponatremia of any degree.<h4>Methods and findings</h4>An extensive Medline, Embase and Cochrane search was performed to retrieve the studies published up to October 1st 2012, using the following words: "hyponatremia" and "mortality". Eighty-one studies satisfied inclusion criteria encompassing a total of 850222 patients, of whom 17.4% were hyponatremic. The identification of relevant abstracts, the selection of studies and the subsequent data extraction were performed independently by two of the authors, and conflicts resolved by a third investigator. Across all 81 studies, hyponatremia was significantly associated with an increased risk of overall mortality (RR = 2.60[2.31-2.93]). Hyponatremia was also associated with an increased risk of mortality in patients with myocardial infarction (RR = 2.83[2.23-3.58]), heart failure (RR = 2.47[2.09-2.92]), cirrhosis (RR = 3.34[1.91-5.83]), pulmonary infections (RR = 2.49[1.44-4.30]), mixed diseases (RR = 2.59[1.97-3.40]), and in hospitalized patients (RR = 2.48[2.09-2.95]). A mean difference of serum [Na(+)] of 4.8 mmol/L was found in subjects who died compared to survivors (130.1 ± 5.6 vs 134.9 ± 5.1 mmol/L). A meta-regression analysis showed that the hyponatremia-related risk of overall mortality was inversely correlated with serum [Na(+)]. This association was confirmed in a multiple regression model after adjusting for age, gender, and diabetes mellitus as an associated morbidity.<h4>Conclusions</h4>This meta-analysis shows for the first time that even a moderate serum [Na(+)] decrease is associated with an increased risk of mortality in commonly observed clinical conditions across large numbers of patients.
format	article
author	Giovanni Corona Corinna Giuliani Gabriele Parenti Dario Norello Joseph G Verbalis Gianni Forti Mario Maggi Alessandro Peri
author_facet	Giovanni Corona Corinna Giuliani Gabriele Parenti Dario Norello Joseph G Verbalis Gianni Forti Mario Maggi Alessandro Peri
author_sort	Giovanni Corona
title	Moderate hyponatremia is associated with increased risk of mortality: evidence from a meta-analysis.
title_short	Moderate hyponatremia is associated with increased risk of mortality: evidence from a meta-analysis.
title_full	Moderate hyponatremia is associated with increased risk of mortality: evidence from a meta-analysis.
title_fullStr	Moderate hyponatremia is associated with increased risk of mortality: evidence from a meta-analysis.
title_full_unstemmed	Moderate hyponatremia is associated with increased risk of mortality: evidence from a meta-analysis.
title_sort	moderate hyponatremia is associated with increased risk of mortality: evidence from a meta-analysis.
publisher	Public Library of Science (PLoS)
publishDate	2013
url	https://doaj.org/article/efff7920f6ba496484402c2a6617e9b9
work_keys_str_mv	AT giovannicorona moderatehyponatremiaisassociatedwithincreasedriskofmortalityevidencefromametaanalysis AT corinnagiuliani moderatehyponatremiaisassociatedwithincreasedriskofmortalityevidencefromametaanalysis AT gabrieleparenti moderatehyponatremiaisassociatedwithincreasedriskofmortalityevidencefromametaanalysis AT darionorello moderatehyponatremiaisassociatedwithincreasedriskofmortalityevidencefromametaanalysis AT josephgverbalis moderatehyponatremiaisassociatedwithincreasedriskofmortalityevidencefromametaanalysis AT gianniforti moderatehyponatremiaisassociatedwithincreasedriskofmortalityevidencefromametaanalysis AT mariomaggi moderatehyponatremiaisassociatedwithincreasedriskofmortalityevidencefromametaanalysis AT alessandroperi moderatehyponatremiaisassociatedwithincreasedriskofmortalityevidencefromametaanalysis
_version_	1718421477748899840

Moderate hyponatremia is associated with increased risk of mortality: evidence from a meta-analysis.

Ejemplares similares