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논문분류	춘계학술대회 초록집
제목	The synergistic effects of pre-existing hyponatremia and hospital acquired acute kidney injury on in-hospital mortality: a retrospective cohort study
저자	Sung Woo Lee*, Seon Ha Baek, Ki Young Na, Sejoong Kim
출판정보	2016; 2016(1):
키워드	None
초록	Background: Both hyponatremia and acute kidney injury (AKI) are common and harmful in hospitalized patients. However, their combined effects on patient mortality have been little studied. Methods: We retrospectively enrolled 19191 adult patients who were admitted for 1 year. Pre-existing hyponatremia was defined as a serum sodium level < 135 mmol/L on the first measurement of their admission. AKI was defined as a rise in serum creatinine by ≥ 0.3 mg/dL or ≥ 1.5 times of the baseline value of creatinine during the hospital stay. Results: The prevalence of pre-existing hyponatremia was 8.2%. During a median 6.0 days of hospital stay, the incidence rates of AKI and in-hospital patient mortality were 5.1% and 0.9%, respectively. Pre-existing hyponatremia independently predicted AKI development and in-hospital mortality (adjusted hazard ratio [HR] 1.306, P = 0.004; HR 7.236, P < 0.001, respectively). Both multiplicative and additive interactions between hyponatremia and AKI for in-hospital mortality were found. In subgroup analysis, the AKI group showed higher rates of de novo hypernatremia than the non-AKI group during the admission. De novo hypernatremia in whole study patients was significantly associated with in-hospital mortality with adjusted HR 3.274 (P <0.001), compared to the non-de novo hypernatremia group. Conclusion: Pre-existing hyponatremia may be associated with the development of AKI in hospitalized patients, and both hyponatremia and hospital-acquired AKI could have a synergistic effect on short term patient mortality, which might be related to the inappropriate correction of hyponatremia in AKI patients.
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