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Serum sodium variability and acute kidney injury: a retrospective observational cohort study on a hospitalized population

Aim of our study was to analyze the association between serum sodium (Na) variability and acute kidney injury (AKI) development. We performed a retrospective observational cohort study on the inpatient population admitted to Fondazione Policlinico Universitario A. Gemelli IRCCS between January 1, 20...

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Autores principales: Lombardi, Gianmarco, Ferraro, Pietro Manuel, Naticchia, Alessandro, Gambaro, Giovanni
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8049924/
https://www.ncbi.nlm.nih.gov/pubmed/32776204
http://dx.doi.org/10.1007/s11739-020-02462-5
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author Lombardi, Gianmarco
Ferraro, Pietro Manuel
Naticchia, Alessandro
Gambaro, Giovanni
author_facet Lombardi, Gianmarco
Ferraro, Pietro Manuel
Naticchia, Alessandro
Gambaro, Giovanni
author_sort Lombardi, Gianmarco
collection PubMed
description Aim of our study was to analyze the association between serum sodium (Na) variability and acute kidney injury (AKI) development. We performed a retrospective observational cohort study on the inpatient population admitted to Fondazione Policlinico Universitario A. Gemelli IRCCS between January 1, 2010 and December 31, 2014 with inclusion of adult patients with ≥ 2 Na and ≥ 2 serum creatinine measurements. We included only patients with ≥ 2 Na measurements before AKI development. The outcome of interest was AKI. The exposures of interest were hyponatremia, hypernatremia and Na fluctuations before AKI development. Na variability was evaluated using the coefficient of variation (CV). Multivariable Cox proportional hazards and logistic regression models were fitted to obtain hazard ratios (HRs), odds ratios (ORs) and 95% confidence intervals (CIs) for the association between the exposures of interest and AKI. Overall, 56,961 patients met our inclusion criteria. During 1541 person-years of follow-up AKI occurred in 1450 patients. In multivariable hazard models, patients with pre-existent dysnatremia and those who developed dysnatremia had a higher risk of AKI compared with patients with normonatremia. Logistic models suggested a higher risk for AKI in the 3rd (OR 1.41, 95% CI 1.18, 1.70, p < 0.001) and 4th (OR 1.53, 95% CI 1.24, 1.91, p < 0.001) highest quartiles of Na CV with a significant linear trend across quartiles (p trend < 0.001). This association was also independent from Na highest and lowest peak value. Dysnatremia is a common condition and is positive associated with AKI development. Furthermore, high Na variability might be considered an independent early indicator for kidney injury development. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s11739-020-02462-5) contains supplementary material, which is available to authorized users.
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spelling pubmed-80499242021-04-29 Serum sodium variability and acute kidney injury: a retrospective observational cohort study on a hospitalized population Lombardi, Gianmarco Ferraro, Pietro Manuel Naticchia, Alessandro Gambaro, Giovanni Intern Emerg Med Im - Original Aim of our study was to analyze the association between serum sodium (Na) variability and acute kidney injury (AKI) development. We performed a retrospective observational cohort study on the inpatient population admitted to Fondazione Policlinico Universitario A. Gemelli IRCCS between January 1, 2010 and December 31, 2014 with inclusion of adult patients with ≥ 2 Na and ≥ 2 serum creatinine measurements. We included only patients with ≥ 2 Na measurements before AKI development. The outcome of interest was AKI. The exposures of interest were hyponatremia, hypernatremia and Na fluctuations before AKI development. Na variability was evaluated using the coefficient of variation (CV). Multivariable Cox proportional hazards and logistic regression models were fitted to obtain hazard ratios (HRs), odds ratios (ORs) and 95% confidence intervals (CIs) for the association between the exposures of interest and AKI. Overall, 56,961 patients met our inclusion criteria. During 1541 person-years of follow-up AKI occurred in 1450 patients. In multivariable hazard models, patients with pre-existent dysnatremia and those who developed dysnatremia had a higher risk of AKI compared with patients with normonatremia. Logistic models suggested a higher risk for AKI in the 3rd (OR 1.41, 95% CI 1.18, 1.70, p < 0.001) and 4th (OR 1.53, 95% CI 1.24, 1.91, p < 0.001) highest quartiles of Na CV with a significant linear trend across quartiles (p trend < 0.001). This association was also independent from Na highest and lowest peak value. Dysnatremia is a common condition and is positive associated with AKI development. Furthermore, high Na variability might be considered an independent early indicator for kidney injury development. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s11739-020-02462-5) contains supplementary material, which is available to authorized users. Springer International Publishing 2020-08-09 2021 /pmc/articles/PMC8049924/ /pubmed/32776204 http://dx.doi.org/10.1007/s11739-020-02462-5 Text en © The Author(s) 2020 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Im - Original
Lombardi, Gianmarco
Ferraro, Pietro Manuel
Naticchia, Alessandro
Gambaro, Giovanni
Serum sodium variability and acute kidney injury: a retrospective observational cohort study on a hospitalized population
title Serum sodium variability and acute kidney injury: a retrospective observational cohort study on a hospitalized population
title_full Serum sodium variability and acute kidney injury: a retrospective observational cohort study on a hospitalized population
title_fullStr Serum sodium variability and acute kidney injury: a retrospective observational cohort study on a hospitalized population
title_full_unstemmed Serum sodium variability and acute kidney injury: a retrospective observational cohort study on a hospitalized population
title_short Serum sodium variability and acute kidney injury: a retrospective observational cohort study on a hospitalized population
title_sort serum sodium variability and acute kidney injury: a retrospective observational cohort study on a hospitalized population
topic Im - Original
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8049924/
https://www.ncbi.nlm.nih.gov/pubmed/32776204
http://dx.doi.org/10.1007/s11739-020-02462-5
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