Prevalence and clinical significance of serum sodium variability in patients with acute-on-chronic liver diseases: a prospective multicenter study in China

BACKGROUND: No reports exist regarding the prevalence of different Na levels and their relationship with 90-day prognosis in hospitalized patients with acute-on-chronic liver disease (AoCLD) in China. Therefore, the benefit of hyponatremia correction in AoCLD patients remains unclear. METHODS: We pr...

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Detalles Bibliográficos
Autores principales: Mei, Xue, Li, Hai, Deng, Guohong, Wang, Xianbo, Zheng, Xin, Huang, Yan, Chen, Jinjun, Meng, Zhongji, Gao, Yanhang, Liu, Feng, Lu, Xiaobo, Shi, Yu, Zheng, Yubao, Yan, Huadong, Zhang, Weituo, Qiao, Liang, Gu, Wenyi, Zhang, Yan, Xiang, Xiaomei, Zhou, Yi, Sun, Shuning, Hou, Yixin, Zhang, Qun, Xiong, Yan, Zou, Congcong, Chen, Jun, Huang, Zebing, Li, Beiling, Jiang, Xiuhua, Zhong, Guotao, Wang, Haiyu, Chen, Yuanyuan, Luo, Sen, Gao, Na, Liu, Chunyan, Li, Jing, Li, Tao, Zheng, Rongjiong, Zhou, Xinyi, Ren, Haotang, Yuan, Wei, Qian, Zhiping
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer India 2022
Materias:
Original Article
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8761510/
https://www.ncbi.nlm.nih.gov/pubmed/35037228
http://dx.doi.org/10.1007/s12072-021-10282-8
Descripción
Sumario:BACKGROUND: No reports exist regarding the prevalence of different Na levels and their relationship with 90-day prognosis in hospitalized patients with acute-on-chronic liver disease (AoCLD) in China. Therefore, the benefit of hyponatremia correction in AoCLD patients remains unclear. METHODS: We prospectively collected the data of 3970 patients with AoCLD from the CATCH-LIFE cohort in China. The prevalence of different Na levels (≤ 120; 120–135; 135–145; > 145) and their relationship with 90-day prognosis were analyzed. For hyponatremic patients, we measured Na levels on days 4 and 7 and compared their characteristics, based on whether hyponatremia was corrected. RESULTS: A total of 3880 patients were involved; 712 of those developed adverse outcomes within 90 days. There were 80 (2.06%) hypernatremic, 28 (0.72%) severe hyponatremic, and 813 (20.95%) mild hyponatremic patients at admission. After adjusting for all confounding factors, the risk of 90-day adverse outcomes decreased by 5% (odds ratio [OR] 0.95; 95% confidence interval [CI] 0.93–0.97; p < 0.001), 24% (OR 0.76; 95% CI 0.70–0.84; p < 0.001), and 42% (OR 0.58; 95% CI 0.49–0.70; p < 0.001) as Na level increased by 1, 5, and 10 mmol/L, respectively. Noncorrection of hyponatremia on days 4 and 7 was associated with 2.05-fold (hazard ratio [HR], 2.05; 95% CI, 1.50–2.79; p < 0.001) and 1.46-fold (HR 1.46; 95% CI 1.05–2.02; p = 0.028) higher risk of adverse outcomes. CONCLUSIONS: Hyponatremia was an independent risk factor for a poor 90-day prognosis in patients with AoCLD. Failure to correct hyponatremia in a week after admission was often associated with increased mortality. (ClinicalTrials.gov number: NCT02457637, NCT03641872). CLINICAL TRIAL NUMBERS: This study is registered at Shanghai www.clinicaltrials.org (NCT02457637 and NCT03641872). SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s12072-021-10282-8.

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