Korean Journal of Nephrology 1990;9(2):162-168.

입원 환자에서 관찰된 저나트륨혈증의 임상상에 관한 연구

박정식 , 박수길 , 이영천 , 김동환 , 전노원 , 오하영

Abstract

To Investigate the frequency, cause, outcome and clincal significance of hyponatremia, which is the most common abnormalties in hospitalized patients in Korea, we have analyzed 308 patients with serum sodium val- ues lower than 130 mEq/L at least two times during hospital course. The resuls were as follows: 1) The overall incidence of hyponatremia in hospital- ized patients was 0.9% (308/34635) Z) Hyponatremia was more common in male patient (M: F=1.6:1) and 70 percent of them was found to have developed before admission. 3) Among the 265 patients whose volume status could be assessed, 82 patients (30.9%) were edematous, 103 patients (38.9%) euvolemic, 39 patients (14.7%) hypovolemic and 41 patients (15.5%) had renal failure. 4) The most common underlying disorders of hypanatremia were hepatic faiure (64.6%) in edematous conditions, pulmonary disease (33.0%.) in euvolemic sta- tus, and gastrointestinal loss (25.6%) in hypovolemic status. 5) The mortality rate of hyponatremic patients was 11.39. (35/308) which was significantly higher than that of general hospitalized had renal failure. 4) The most common underlying disorders of hypanatremia were hepatic faiure (64.6%) in edematous conditions, pulmonary disease (33.0%.) in euvolemic sta- tus, and gastrointestinal loss (25.6%) in hypovolemic status. 5) The mortality rate of hyponatremic patients was 11.39. (35/308) which was significantly higher than that of general hospitalized patients. (2.0%, 698/34635). And the patients with persistent hyponatremia (17.9 vs 4.6%) or lower nadir value of serum sodium concentration (18. 8% vs 8.7%) also had higher mortality. 6) The major causes of death were intractable hepatic failure (20%), respiratory failure (20%) and heart failure (14.3%). From this it seems that hyponatremia was not an independent prognostic factor but just an indicator of severity of underlying diseases.