Hyponatremia, hypernatremia, and mortality in patients with chronic kidney disease with and without congestive heart failure

Csaba P. Kovesdy, Evan H. Lott, Jun Ling Lu, Sandra M. Malakauskas, Jennie Z. Ma, M. Molnár, Kamyar Kalantar-Zadeh

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Abstract

Background-Hyponatremia is common in patients with conditions such as congestive heart failure and is associated with increased mortality in hospitalized patients. Congestive heart failure is common in patients with chronic kidney disease, but the association of serum sodium concentration with mortality in such patients is not well characterized. Methods and Results-We examined the association of serum sodium concentration with all-cause mortality in a nationally representative cohort of 655 493 US veterans with non-dialysis-dependent chronic kidney disease (95 961 [15%] of them with congestive heart failure). Associations were examined in time-dependent Cox models with adjustment for potential confounders. During a median follow-up of 5.5 years, a total of 193 956 patients died (mortality rate, 62.5/1000 patient-years; 95% confidence interval, 62.2-62.8). The association of serum sodium level with mortality was U-shaped, with the lowest mortality seen in patients with sodium level of 140 mEq/L and with both lower and higher levels showing significant associations with increased mortality. Patients with serum sodium levels of

Original languageEnglish
Pages (from-to)677-684
Number of pages8
JournalCirculation
Volume125
Issue number5
DOIs
Publication statusPublished - Feb 7 2012

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Hypernatremia
Hyponatremia
Chronic Renal Insufficiency
Heart Failure
Mortality
Sodium
Serum
Veterans
Proportional Hazards Models
Confidence Intervals

ASJC Scopus subject areas

  • Physiology (medical)
  • Cardiology and Cardiovascular Medicine

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Hyponatremia, hypernatremia, and mortality in patients with chronic kidney disease with and without congestive heart failure. / Kovesdy, Csaba P.; Lott, Evan H.; Lu, Jun Ling; Malakauskas, Sandra M.; Ma, Jennie Z.; Molnár, M.; Kalantar-Zadeh, Kamyar.

In: Circulation, Vol. 125, No. 5, 07.02.2012, p. 677-684.

Research output: Contribution to journalArticle

Kovesdy, Csaba P. ; Lott, Evan H. ; Lu, Jun Ling ; Malakauskas, Sandra M. ; Ma, Jennie Z. ; Molnár, M. ; Kalantar-Zadeh, Kamyar. / Hyponatremia, hypernatremia, and mortality in patients with chronic kidney disease with and without congestive heart failure. In: Circulation. 2012 ; Vol. 125, No. 5. pp. 677-684.
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