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논문분류	춘계학술대회 초록집
제목	Serum Sodium Level Within Normal Range and Risk of Clinical Outcomes in Older Adults with Chronic Kidney Disease
저자	Hyoungnae Kim
출판정보	2026; 2026(1):
키워드	sodium, chronic kidney disease, older adults, mortality
초록	Objectives: Sodium imbalance is a common electrolyte abnormality in patient with chronic kidney disease (CKD). Emerging evidence suggests that even small variations in serum sodium levels within the normal range may be associated with adverse clinical outcomes in older populations. Therefore, we aimed to investigate the association between serum sodium levels and clinical outcomes in older adults with CKD. Methods: This study included 746 older adults with non-dialysis CKD enrolled in the Korean Society of Geriatric Nephrology prospective cohort from 17 centers in South Korea. Patients were categorized into two groups according to baseline serum sodium levels: 135-139 mmol/L (low-normal) and 140-145 mmol/L (high-normal). The primary outcome was all-cause mortality and secondary outcomes were the incidence of end-stage kidney disease (ESKD) and cardiovascular disease (CVD). Results: The mean age was 78 years and 40.5% was female. During a median follow-up of 3.3 years, patients in the high-normal group had significantly lower risk of mortality compared with those in the low-normal group (hazard ratio [HR], 0.62; 95% confidence interval [CI], 0.40-0.96; p=0.034). In addition, this association remained significant after correcting serum sodium levels for fasting glucose. In a time-varying Cox proportional hazards model, each 1 mmol/L increase in serum sodium was associated with a 7% lower hazard of mortality (HR, 0.93; 95% CI, 0.87–0.99; p=0.027). However, serum sodium levels were not significantly associated with the risk of ESKD or CVD. Conclusion: Higher serum sodium levels within the normal range were associated with a lower risk of mortality in older adults with CKD. These findings suggest that variations in serum sodium levels, even within the normal range, may have prognostic significance in this population.
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