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Changes in Serum Creatinine Levels Can Help Distinguish Hypovolemic from Euvolemic Hyponatremia
Background and Objectives: Differentiating between hypovolemic (HH) and euvolemic hyponatremia (EH) is crucial for correct diagnosis and therapy, but can be a challenge. We aim to ascertain whether changes in serum creatinine (SC) can be helpful in distinguishing HH from EH. Materials and Methods: R...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9323891/ https://www.ncbi.nlm.nih.gov/pubmed/35888570 http://dx.doi.org/10.3390/medicina58070851 |
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author | Ruiz-Sánchez, Jorge Gabriel Cuesta, Martín Gómez-Hoyos, Emilia Cárdenas-Salas, Jersy Rubio-Herrera, Miguel Ángel Martínez-González, Estefanía De Miguel Novoa, Paz Ternero-Vega, Jara Eloisa Calle-Pascual, Alfonso Luis Runkle, Isabelle |
author_facet | Ruiz-Sánchez, Jorge Gabriel Cuesta, Martín Gómez-Hoyos, Emilia Cárdenas-Salas, Jersy Rubio-Herrera, Miguel Ángel Martínez-González, Estefanía De Miguel Novoa, Paz Ternero-Vega, Jara Eloisa Calle-Pascual, Alfonso Luis Runkle, Isabelle |
author_sort | Ruiz-Sánchez, Jorge Gabriel |
collection | PubMed |
description | Background and Objectives: Differentiating between hypovolemic (HH) and euvolemic hyponatremia (EH) is crucial for correct diagnosis and therapy, but can be a challenge. We aim to ascertain whether changes in serum creatinine (SC) can be helpful in distinguishing HH from EH. Materials and Methods: Retrospective analysis of patients followed in a monographic hyponatremia outpatient clinic of a tertiary hospital during 1 January 2014–30 November 2019. SC changes during HH and EH from eunatremia were studied. The diagnostic accuracy of the SC change from eunatremia to hyponatremia (∆SC) was analyzed. Results: A total of 122 hyponatremic patients, median age 79 years (70–85), 46.7% women. In total, 70/122 patients had EH, 52/122 HH. During hyponatremia, median SC levels increased in the HH group: +0.18 mg/dL [0.09–0.39, p < 0.001], but decreased in the EH group: −0.07 mg/dL (−0.15–0.02, p < 0.001), as compared to SC in eunatremia. HH subjects presented a higher rate of a positive ∆SC than EH (90.4% vs. 25.7%, p < 0.001). EH subjects presented a higher rate of a negative/null ∆SC than HH (74.3% vs. 9.6%, p < 0.001). ROC curve analysis found an AUC of 0.908 (95%CI: 0.853 to 0.962, p < 0.001) for ∆SC%. A ∆SC% ≥ 10% had an OR of 29.0 (95%CI: 10.3 to 81.7, p < 0.001) for HH. A ∆SC% ≤ 3% had an OR of 68.3 (95%CI: 13.0 to 262.2, p < 0.001) for EH. Conclusions: The assessment of SC changes from eunatremia to hyponatremia can be useful in distinguishing between HH and EH. |
format | Online Article Text |
id | pubmed-9323891 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-93238912022-07-27 Changes in Serum Creatinine Levels Can Help Distinguish Hypovolemic from Euvolemic Hyponatremia Ruiz-Sánchez, Jorge Gabriel Cuesta, Martín Gómez-Hoyos, Emilia Cárdenas-Salas, Jersy Rubio-Herrera, Miguel Ángel Martínez-González, Estefanía De Miguel Novoa, Paz Ternero-Vega, Jara Eloisa Calle-Pascual, Alfonso Luis Runkle, Isabelle Medicina (Kaunas) Article Background and Objectives: Differentiating between hypovolemic (HH) and euvolemic hyponatremia (EH) is crucial for correct diagnosis and therapy, but can be a challenge. We aim to ascertain whether changes in serum creatinine (SC) can be helpful in distinguishing HH from EH. Materials and Methods: Retrospective analysis of patients followed in a monographic hyponatremia outpatient clinic of a tertiary hospital during 1 January 2014–30 November 2019. SC changes during HH and EH from eunatremia were studied. The diagnostic accuracy of the SC change from eunatremia to hyponatremia (∆SC) was analyzed. Results: A total of 122 hyponatremic patients, median age 79 years (70–85), 46.7% women. In total, 70/122 patients had EH, 52/122 HH. During hyponatremia, median SC levels increased in the HH group: +0.18 mg/dL [0.09–0.39, p < 0.001], but decreased in the EH group: −0.07 mg/dL (−0.15–0.02, p < 0.001), as compared to SC in eunatremia. HH subjects presented a higher rate of a positive ∆SC than EH (90.4% vs. 25.7%, p < 0.001). EH subjects presented a higher rate of a negative/null ∆SC than HH (74.3% vs. 9.6%, p < 0.001). ROC curve analysis found an AUC of 0.908 (95%CI: 0.853 to 0.962, p < 0.001) for ∆SC%. A ∆SC% ≥ 10% had an OR of 29.0 (95%CI: 10.3 to 81.7, p < 0.001) for HH. A ∆SC% ≤ 3% had an OR of 68.3 (95%CI: 13.0 to 262.2, p < 0.001) for EH. Conclusions: The assessment of SC changes from eunatremia to hyponatremia can be useful in distinguishing between HH and EH. MDPI 2022-06-25 /pmc/articles/PMC9323891/ /pubmed/35888570 http://dx.doi.org/10.3390/medicina58070851 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Ruiz-Sánchez, Jorge Gabriel Cuesta, Martín Gómez-Hoyos, Emilia Cárdenas-Salas, Jersy Rubio-Herrera, Miguel Ángel Martínez-González, Estefanía De Miguel Novoa, Paz Ternero-Vega, Jara Eloisa Calle-Pascual, Alfonso Luis Runkle, Isabelle Changes in Serum Creatinine Levels Can Help Distinguish Hypovolemic from Euvolemic Hyponatremia |
title | Changes in Serum Creatinine Levels Can Help Distinguish Hypovolemic from Euvolemic Hyponatremia |
title_full | Changes in Serum Creatinine Levels Can Help Distinguish Hypovolemic from Euvolemic Hyponatremia |
title_fullStr | Changes in Serum Creatinine Levels Can Help Distinguish Hypovolemic from Euvolemic Hyponatremia |
title_full_unstemmed | Changes in Serum Creatinine Levels Can Help Distinguish Hypovolemic from Euvolemic Hyponatremia |
title_short | Changes in Serum Creatinine Levels Can Help Distinguish Hypovolemic from Euvolemic Hyponatremia |
title_sort | changes in serum creatinine levels can help distinguish hypovolemic from euvolemic hyponatremia |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9323891/ https://www.ncbi.nlm.nih.gov/pubmed/35888570 http://dx.doi.org/10.3390/medicina58070851 |
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