The Prognostic Importance of Serum Sodium for Mortality among Critically Ill Patients Requiring Continuous Renal Replacement Therapy
Issued Date
2022-03-01
Resource Type
ISSN
16608151
eISSN
22353186
Scopus ID
2-s2.0-85120747988
Pubmed ID
34794149
Journal Title
Nephron
Volume
146
Issue
2
Start Page
153
End Page
159
Rights Holder(s)
SCOPUS
Bibliographic Citation
Nephron Vol.146 No.2 (2022) , 153-159
Suggested Citation
Petnak T., Thongprayoon C., Cheungpasitporn W., Shawwa K., Mao M.A., Kashani K.B. The Prognostic Importance of Serum Sodium for Mortality among Critically Ill Patients Requiring Continuous Renal Replacement Therapy. Nephron Vol.146 No.2 (2022) , 153-159. 159. doi:10.1159/000519686 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/83813
Title
The Prognostic Importance of Serum Sodium for Mortality among Critically Ill Patients Requiring Continuous Renal Replacement Therapy
Author's Affiliation
Other Contributor(s)
Abstract
Background: Serum sodium derangement is common in critically ill patients requiring continuous renal replacement therapy (CRRT). We aimed to assess the association between serum sodium before and during CRRT with mortality. Methods: This is a historical cohort study of 1,520 critically ill patients receiving CRRT from December 2006 through November 2015 in a tertiary hospital in the United States. Using logistic regression analysis, we used serum sodium before CRRT, mean serum sodium, and serum sodium changes during CRRT to predict 90-day mortality after CRRT initiation. Results: Compared with the normal serum sodium levels, the odds ratio (OR) of 90-day mortality in patients with serum sodium before CRRT of 143-147 and ≥148 mmol/L were 1.45 (95% CI 1.03-2.05) and 2.24 (95% CI 1.33-3.87), respectively. There was no significant increase in 90-day mortality in serum sodium of ≤137 mmol/L. During CRRT, the mean serum sodium levels of ≤137 (OR 1.41; 95% CI 1.01-1.98) and ≥143 mmol/L (OR 1.52; 95% CI 1.14-2.03) were associated with higher 90-day mortality. The greater serum sodium changes during CRRT were associated with higher 90-mortality (OR 1.35; 95% CI 1.21-1.51 per 5-mmol/L increase). Conclusion: Before CRRT initiation, hypernatremia and during CRRT, hypo- and hypernatremia were associated with increased mortality.