Why hyperglycemia causes hyponatremia

Whether treatments or changes to sodium levels during the hospital stay impacted outcomes is not known. Second, this study was conducted in a tertiary medical center; thus, the result may not be applicable universally. Third, we did not collect information of some possible confounding factors that may have influenced serum sodium levels or mortality rate, including underlying diseases, medications, and certain laboratory tests not conducted routinely, such as lactate and blood gas levels.

These factors might have affected the results. Fourth, we did not analyze the cause of mortality between the groups due to scanty information on mortality events.

The all-cause day mortality rate was Therefore, area under the curve of receiver operating characteristic curve might not be appropriate to compare the diagnostic performance between serum glucose levels, measured sodium levels, and corrected sodium levels. Further multicenter studies with larger sample sizes and comprehensive clinical databases are needed to demonstrate the relationship between sodium levels and clinical outcomes.

In conclusion, dysnatremia after correction by serum glucose level is associated with worse clinical outcomes and higher day mortality rate in hyperglycemic patients. Corrected sodium level is a better indicator of prognosis compared with measured sodium, as the former could be easily interpreted based on usual laboratory references. Further well-designed case—control studies are warranted to confirm the relationship.

Conflicts of interest: The authors declare that they have no conflicts of interest related to the subject matter or materials discussed in this article.

National Center for Biotechnology Information , U. Journal of the Chinese Medical Association. J Chin Med Assoc. Published online Aug Author information Article notes Copyright and License information Disclaimer. E-mail address: wt. Received Jan 29; Accepted May This article has been cited by other articles in PMC.

Abstract Background: Abnormal serum sodium levels in various diseases increase mortality; however, hyperglycemia depresses serum sodium concentration significantly.

Results: A total of patients with severe hyperglycemia were enrolled, and the day mortality was Conclusion: Among patients with severe hyperglycemia, corrected sodium level is a better indicator of clinical outcomes compared with measured sodium levels, especially in this population with measured hyponatremia.

Keywords: Corrected sodium levels, Hyperglycemia, Mortality. Grouping according to measured or corrected sodium levels The sodium level was corrected according to the glucose level, with a correction factor of a 2. Study outcomes The primary outcome for this analysis was all-cause day mortality. Table 1 Baseline characteristics of patients according to corrected sodium levels.

Open in a separate window. Primary outcomes Among the patients with severe hyperglycemia, the day mortality was Table 2 Hazard ratios for day mortality according to the measured sodium level. Table 3 Hazard ratios for day mortality according to the corrected sodium level.

Footnotes Conflicts of interest: The authors declare that they have no conflicts of interest related to the subject matter or materials discussed in this article. References 1. Incidence and prevalence of hyponatremia. Am J Med ; 7 Suppl 1 S30—5. N Engl J Med ; —9. Hyponatremia: evaluating the correction factor for hyperglycemia. Am J Med ; — Diabetes mellitus and electrolyte disorders. World J Clin Cases ; 2 — Hyponatremia and mortality risk: a Danish cohort study of acutely hospitalized patients.

Eur J Endocrinol ; — Impact of hospital-associated hyponatremia on selected outcomes. Arch Intern Med ; — Hepatology ; 44 — Eur Heart J ; 28 —8.

Associations of dysnatremias with mortality in chronic kidney disease. Nephrol Dial Transplant ; 32 — Hyponatremia and mortality among patients on the liver-transplant waiting list. N Engl J Med ; — It is not clearly understood why patients with pulmonary hypertension PH develop pericardial effusions. The two drugs are not interchangeable nor dose equivalents.

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