| Acute kidney injury in patients presenting with hyponatremia. | |
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MedLine Citation:
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PMID: 21374587 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Hyponatremia is the most common electrolyte disorder, but a lack of well-characterized cohorts is hindering a full appreciation of this complex and heterogeneous disorder. METHODS: During 4 months, clinical, biochemical, treatment and outcome data were collected for patients presenting with hyponatremia (serum sodium =130 mmol/L) to an urban university hospital. RESULTS: Forty-three patients were included (serum sodium 126.6 ± 3.7 mmol/L). The most common causes of hyponatremia were diuretics (n=12), syndrome of inappropriate antidiuretic hormone secretion (n=11) and heart or liver disease (n=5). Renal insufficiency was frequent (n=18, 42%), and usually represented acute kidney injury (AKI; n=14, 78%). In patients with AKI, admission serum creatinine was 271 ± 252 µmol/L (3.4 ± 3.1-fold increase from baseline) and the origin was usually prerenal (12/14, 86%, fractional sodium excretion 0.54% ± 0.38%). Of these, patients with potentially reversible causes (salt loss or sepsis, n=7) had more favorable outcomes than patients with severe underlying disease (heart or liver disease, n=5), despite similar predictions using the RIFLE criteria. Survivors recovered with fluid resuscitation only. No overly rapid correction of hyponatremia was observed. CONCLUSIONS: AKI is common in patients presenting with hyponatremia and is usually of prerenal origin. The concurrence of AKI and hyponatremia has previously not been emphasized, but is important pathophysiologically and to plan rational management for both disorders. In this cohort, isotonic fluid replacement corrected both disorders and did not lead to overly rapid correction of hyponatremia. |
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Authors:
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Denise Adams; Robert de Jonge; Tischa van der Cammen; Robert Zietse; Ewout J Hoorn |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of nephrology Volume: 24 ISSN: 1724-6059 ISO Abbreviation: J. Nephrol. Publication Date: 2011 Nov-Dec |
Date Detail:
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Created Date: 2011-11-07 Completed Date: 2012-04-18 Revised Date: 2012-04-27 |
Medline Journal Info:
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Nlm Unique ID: 9012268 Medline TA: J Nephrol Country: Italy |
Other Details:
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Languages: eng Pagination: 749-55 Citation Subset: IM |
Affiliation:
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Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Acute Kidney Injury
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blood,
epidemiology*,
physiopathology* Adult Aged Cohort Studies Comorbidity Creatinine / blood Female Fluid Therapy* Humans Hyponatremia / epidemiology*, physiopathology*, therapy Male Middle Aged Prospective Studies Retrospective Studies Sodium / blood Treatment Outcome Water-Electrolyte Imbalance / physiopathology |
| Chemical | |
Reg. No./Substance:
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60-27-5/Creatinine; 7440-23-5/Sodium |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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