Yukyung Kim1,2, Nari Lee3, Kyung Eun Lee4, Hye Sun Gwak5,6. 1. Graduate School of Converging Clinical & Public Health, Ewha Womans University, Seoul, 03760, South Korea. 2. Department of Pharmacy, Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, 06591, South Korea. 3. College of Pharmacy and Graduate School of Pharmaceutical Sciences, Ewha Womans University, 52 Ewhayeodae-gil, Seodaemun-gu, Seoul, 03760, South Korea. 4. College of Pharmacy, Chungbuk National University, 660-1, Yeonje-ri, Osong-eup, Heungdeok-gu, Cheongju-si, 28160, South Korea. kaylee@cbnu.ac.kr. 5. Graduate School of Converging Clinical & Public Health, Ewha Womans University, Seoul, 03760, South Korea. hsgwak@ewha.ac.kr. 6. College of Pharmacy and Graduate School of Pharmaceutical Sciences, Ewha Womans University, 52 Ewhayeodae-gil, Seodaemun-gu, Seoul, 03760, South Korea. hsgwak@ewha.ac.kr.
Abstract
PURPOSE: In this study, the risk factors associated with sodium overcorrection were investigated with an optimal cutoff for baseline serum sodium for use in daily clinical practice. METHODS: Electronic medical records of patients who received tolvaptan for non-hypovolemic hyponatremia were reviewed. Demographic and clinical data including age, sex, weight, height, comorbidity, cause of hyponatremia, hypertonic saline use, and comedication were collected. Baseline laboratory parameters measured included serum sodium, serum potassium, serum creatinine, blood urea nitrogen, serum tonicity, ALT, AST, and urine osmolality. The primary outcome was the overcorrection of serum sodium, which was defined as an increase in serum sodium by more than 10 mmol/L in 24 h. RESULTS: From a total of 77 patients included in the analysis, 24 (31.2%) showed sodium overcorrection (> 10 mmol/L/24 h); 2 (2.6%) in heart failure cohort, 17 (22.1%) in SIADH cohort, and 5 (6.5%) in unknown cause cohort. More than half of patients (51.9%) were administered hypertonic saline prior to tolvaptan. Hypertension, cancer, diuretics, baseline serum sodium, and SIADH were associated with the risk of overcorrection in the univariable analysis. Significant factors for the overcorrection from multivariable analysis were lower body mass index, presence of cancer (adjusted odds ratio, 10.87; 95% CI, 1.23-96.44), and lower serum sodium at baseline (adjusted odds ratio, 0.76 for every 1 mEq/L increase; 95% CI, 0.61-0.94). CONCLUSION: The overcorrection of hyponatremia in non-hypovolemic patients treated with tolvaptan was significantly associated with lower body mass index, presence of cancer, and lower serum sodium at baseline. In subgroup analysis using SIADH patients, baseline sodium and cancer were found to be significant factors of overcorrection.
PURPOSE: In this study, the risk factors associated with sodium overcorrection were investigated with an optimal cutoff for baseline serum sodium for use in daily clinical practice. METHODS: Electronic medical records of patients who received tolvaptan for non-hypovolemic hyponatremia were reviewed. Demographic and clinical data including age, sex, weight, height, comorbidity, cause of hyponatremia, hypertonicsaline use, and comedication were collected. Baseline laboratory parameters measured included serum sodium, serum potassium, serum creatinine, blood ureanitrogen, serum tonicity, ALT, AST, and urine osmolality. The primary outcome was the overcorrection of serum sodium, which was defined as an increase in serum sodium by more than 10 mmol/L in 24 h. RESULTS: From a total of 77 patients included in the analysis, 24 (31.2%) showed sodium overcorrection (> 10 mmol/L/24 h); 2 (2.6%) in heart failure cohort, 17 (22.1%) in SIADH cohort, and 5 (6.5%) in unknown cause cohort. More than half of patients (51.9%) were administered hypertonicsaline prior to tolvaptan. Hypertension, cancer, diuretics, baseline serum sodium, and SIADH were associated with the risk of overcorrection in the univariable analysis. Significant factors for the overcorrection from multivariable analysis were lower body mass index, presence of cancer (adjusted odds ratio, 10.87; 95% CI, 1.23-96.44), and lower serum sodium at baseline (adjusted odds ratio, 0.76 for every 1 mEq/L increase; 95% CI, 0.61-0.94). CONCLUSION: The overcorrection of hyponatremia in non-hypovolemicpatients treated with tolvaptan was significantly associated with lower body mass index, presence of cancer, and lower serum sodium at baseline. In subgroup analysis using SIADHpatients, baseline sodium and cancer were found to be significant factors of overcorrection.
Authors: Robert W Schrier; Peter Gross; Mihai Gheorghiade; Tomas Berl; Joseph G Verbalis; Frank S Czerwiec; Cesare Orlandi Journal: N Engl J Med Date: 2006-11-14 Impact factor: 91.245
Authors: Michele Umbrello; Elena S Mantovani; Paolo Formenti; Claudia Casiraghi; Davide Ottolina; Martina Taverna; Angelo Pezzi; Giovanni Mistraletti; Gaetano Iapichino Journal: Ann Intensive Care Date: 2016-01-04 Impact factor: 6.925
Authors: Sang Woong Han; Joo Hark Yi; Kyung Pyo Kang; Ha Yeon Kim; Soo Wan Kim; Hoon Young Choi; Sung Kyu Ha; Gheun Ho Kim; Yang Wook Kim; Kyung Hwan Jeong; Sug Kyun Shin; Ho Jung Kim Journal: J Korean Med Sci Date: 2018-04-09 Impact factor: 2.153
Authors: Jorge Gabriel Ruiz-Sánchez; Diego Meneses; Cristina Álvarez-Escolá; Martin Cuesta; Alfonso Luis Calle-Pascual; Isabelle Runkle Journal: J Clin Med Date: 2020-11-05 Impact factor: 4.241
Authors: Eva Perelló-Camacho; Francisco J Pomares-Gómez; Luis López-Penabad; Rosa María Mirete-López; María Rosa Pinedo-Esteban; José Ramón Domínguez-Escribano Journal: Sci Rep Date: 2022-06-17 Impact factor: 4.996