Hyponatremia and mortality in patients undergoing maintenance hemodialysis: Systematic review and meta-analysis.

IF 1.4 4区 医学 Q3 UROLOGY & NEPHROLOGY
Seminars in Dialysis Pub Date : 2023-07-01 Epub Date: 2023-03-16 DOI:10.1111/sdi.13140
Takamasa Miyauchi, Hiroki Nishiwaki, Aya Mizukami, Masahiko Yazawa
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引用次数: 0

Abstract

Introduction: This systematic review and meta-analysis examined the relationship between hyponatremia and worse outcomes in patients undergoing maintenance hemodialysis.

Methods: The MEDLINE, EMBASE, CENTRAL, and Web of Science databases were used to search for relevant articles. The target population was patients on maintenance hemodialysis (those undergoing hemodialysis for ≥60 days). The defined outcomes were death, cardiovascular disease, cognitive decline, and falls. Meta-analysis was performed with a random-effects model of pairwise comparisons of normonatremia and hyponatremia defined for each study, 1-mmol/L increment of sodium analysis, and dose-response analysis using the sodium concentration defined for each study. This study was registered with PROSPERO (registration number CRD42018087667).

Results: Thirteen articles were included. The pairwise analysis revealed that the hazard ratio for all-cause mortality was 1.45 (95% confidence interval, 1.31-1.61). The analysis of 1-mmol/L increment of sodium included six studies with a hazard ratio for all-cause mortality of 0.94 (95% confidence interval, 0.91-0.97) for each 1-mmol/L increase in the serum sodium concentration. In the dose-response analysis, assuming a linear relationship, a sodium increment of 1 mmol/L revealed a hazard ratio for all-cause mortality of 0.97 (95% confidence interval, 0.96-0.98). Other outcomes could not be integrated.

Conclusions: Hyponatremia is associated with all-cause mortality in patients undergoing maintenance hemodialysis. Healthcare providers should pay special attention to even the slightest indication of hyponatremia.

维持性血液透析患者的低钠血症与死亡率:系统综述和荟萃分析。
引言:本系统综述和荟萃分析研究了维持性血液透析患者低钠血症与不良预后之间的关系。方法:使用MEDLINE、EMBASE、CENTRAL和Web of Science数据库检索相关文章。目标人群是接受维持性血液透析的患者(那些接受血液透析≥60 天)。定义的结果是死亡、心血管疾病、认知能力下降和跌倒。荟萃分析采用随机效应模型进行,该模型对每项研究中定义的正常钠血症和低钠血症进行成对比较,钠增量为1mol/L,并使用每项研究定义的钠浓度进行剂量反应分析。本研究已在PROSPERO注册(注册号CRD42018087667)。结果:共收录13篇文章。成对分析显示,全因死亡率的危险比为1.45(95%置信区间,1.31-1.61)。钠浓度增加1mmol/L的分析包括6项研究,血清钠浓度每增加1mmol/L,全因死亡的危险比均为0.94(95%置信间隔,0.91-0.97)。在剂量反应分析中,假设呈线性关系,钠增量为1 mmol/L时,全因死亡率的危险比为0.97(95%置信区间,0.96-0.98)。其他结果无法整合。结论:维持性血液透析患者的低钠血症与全因死亡率相关。医疗保健提供者应特别注意哪怕是最轻微的低钠血症迹象。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Seminars in Dialysis
Seminars in Dialysis 医学-泌尿学与肾脏学
CiteScore
3.00
自引率
6.20%
发文量
91
审稿时长
4-8 weeks
期刊介绍: Seminars in Dialysis is a bimonthly publication focusing exclusively on cutting-edge clinical aspects of dialysis therapy. Besides publishing papers by the most respected names in the field of dialysis, the Journal has unique useful features, all designed to keep you current: -Fellows Forum -Dialysis rounds -Editorials -Opinions -Briefly noted -Summary and Comment -Guest Edited Issues -Special Articles Virtually everything you read in Seminars in Dialysis is written or solicited by the editors after choosing the most effective of nine different editorial styles and formats. They know that facts, speculations, ''how-to-do-it'' information, opinions, and news reports all play important roles in your education and the patient care you provide. Alternate issues of the journal are guest edited and focus on a single clinical topic in dialysis.
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