| Characteristics of Severe Hyponatremia in Hospitalized Patients; A Comparison according to the Presence of Liver Disease |
| Hyosang Kim, M.D.1, Hajeong Lee, M.D.1, Hayne cho Park, M.D.1, Ji Yong Jeong, M.D.1, Min Jeong Son, M.D.1, Kook Hwan Oh, M.D.1, Yon Su Kim, M.D.1, 2, Curie Ahn, M.D.1, 2, Jin Suk Han, M.D.1, Suhnggwon Kim, M.D.1, 2 and Kwon Wook Joo, M.D.1, 2 |
Department of Internal Medicine1
Seoul National University College of Medicine, Renal Research Institute2
Seoul National University College of Medicine |
| 임상연구 : 입원 환자에서 발생한 중증 저나트륨혈증의 임상상 및 경과 분석; 간질환 유무에 따른 비교 |
| 김효상1, 이하정1, 박혜인조1, 정지용1, 손민정1, 오국환1, 김연수1, 2, 안규리1, 2, 한진석1, 김성권1, 2, 주권욱1, 2 |
| 서울대학교 의과대학 내과학교실1, 서울대학교 의학연구원 신장연구소2 |
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| Abstract |
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Purpose : Liver disease is one of the most common causes of hyponatremia and improper management of severe hyponatremia may result in serious complications. We evaluated the prevalence and clinical characteristics of severe hyponatremic patients according to the presence of liver disease in hospitalized patients.
Methods : We studied 12,729 hyponatremic patients during hospitalization in single tertiary referral hospital for 1 year. Hyponatremia was defined as serum sodium level <135 mmol/L and severe hyponatremia as ≤125 mmol/L at least twice.
Results : Of 12,729 hyponatremic patients, 711 (0.13%) patients had severe hyponatremia and 290 (40.8%) patients with severe hyponatremia had liver disease. The main cause of severe hyponatremia was liver failure (69.7%) in patients with liver disease and excessive administration of hypotonic fluid (37.3%) in non-liver disease patients. The administration of hypertonic saline was the most commontreatment both in liver and non-liver disease group. In severe hyponatremic liver disease patients, the serum sodium level was lower (128.8±7.1 at admission, 127.1±8.4 at discharge vs 132.1±7.5, 131.5±8.3 mmol/L) and the duration of severe hyponatremia (5 days vs 3 days) was longer than those in non-liver disease group. Of 589 patients with severe hyponatremic patients who had been treated for the sodium correction, 261 patients were recovered from severe hyponatremia to normal range of serum sodium, and lower correction rate was observed in liver disease group.
Conclusion : Liver failure was the most common cause of severe hyponatremia in hospitalized patients. Severe hyponatremia in patients with liver disease had poor clinical outcomes. |
| Key Words:
Hyponatremia, Liver diseases, Inpatients |
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