Journal article
Hyponatremia is a surrogate marker of poor outcome in peritoneal dialysis-related peritonitis
BMC nephrology, Vol.15(1), pp.113-113
07/10/2014
DOI: 10.1186/1471-2369-15-113
PMCID: PMC4096437
PMID: 25012614
Abstract
Background: Hyponatremia is known to be a marker of poor prognosis in many clinical conditions. The association between hyponatremia and clinical outcomes in peritoneal dialysis-related peritonitis (PDRP) has not been studied. We evaluated the association between hyponatremia and clinical parameters of patients with PDRP.
Methods: We conducted a retrospective analysis of medical records of patients with PDRP admitted to a medical center in the period 2004-2011. Patients with serum Na+ <130 mEq/L and >= 130 mEq/L at admission were divided into hyponatremic and normonatremic groups, respectively. The demographic and laboratory characteristics, pathogens of peritonitis, length of hospital stay and mortality rate were analyzed.
Results: Hyponatremia occurred in 27% (27/99) patients with PDRP. Gram-negative bacilli were the major pathogen responsible for 78% (21/27) PDRP in hyponatremic group while gram-positive cocci were found in 75% (41/55) PDRP in normonatremic groups. There was no significant difference in age, duration of dialysis, PD catheter removal rate and technique failure between two groups. Hyponatremic group had significantly higher serum CRP (p <0.001), lower serum albumin (p < 0.001) and phosphate (p < 0.05). Of note, serum Na+ level was positively correlated with serum albumin (p < 0.001), phosphate (p < 0.04) levels, and subjective global assessment (SGA) score (p < 0.001). Moreover, the length of hospital stay was longer and in-hospital mortality rate was higher in hyponatremic group (p < 0.001). Using a multivariable logistic regression, we showed that hyponatremia at admission is an independent predictor of in-hospital mortality (OR 76.89 95% CI 3.39-1741.67, p < 0.05) and long hospital stay (OR 5.37, 95% CI 1.58-18.19, p < 0.05).
Conclusions: In uremic patients with PDRP, hyponatremia at admission associated with a high frequency of gram negative bacilli infection, low serum albumin and phosphate levels, low SGA score, and poor prognosis with long hospital stay and high mortality rate.
Details
- Title: Subtitle
- Hyponatremia is a surrogate marker of poor outcome in peritoneal dialysis-related peritonitis
- Creators
- Min-Hua Tseng - Chang Gung UniversityChih-Jen Cheng - National Defense Medical CenterChih-Chien Sung - National Defense Medical CenterYu-Ching Chou - National Defense Medical CenterPauling Chu - National Defense Medical CenterGiien Shuen Chen - National Defense Medical CenterShih-Hua Lin - National Defense Medical Center
- Resource Type
- Journal article
- Publication Details
- BMC nephrology, Vol.15(1), pp.113-113
- DOI
- 10.1186/1471-2369-15-113
- PMID
- 25012614
- PMCID
- PMC4096437
- NLM abbreviation
- BMC Nephrol
- ISSN
- 1471-2369
- eISSN
- 1471-2369
- Publisher
- Springer Nature
- Number of pages
- 7
- Language
- English
- Date published
- 07/10/2014
- Academic Unit
- Nephrology; Internal Medicine
- Record Identifier
- 9984383918902771
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