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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...

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Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
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.
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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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