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논문분류	춘계학술대회 초록집
제목	Serum Sodium Level and Outcomes in Patients Initiating Hemodialysis
저자	Sungjin Chung1, Hyung Wook Kim1, Su-Hyun Kim2, Young Ok Kim1, Dong Chan Jin1,Ho Chul Song1, Euy Jin Choi1, Yong-Lim Kim3, Yon-Su Kim4, Shin-Wook Kang5,Nam-Ho Kim6, Chul Woo Yang1, Yong Kyun Kim1
출판정보	2014; 2014(1):
키워드	혈액투석, 나트륨, 사망률
초록	Background: It is well-known that chronic kidney disease (CKD) affects the ability of the kidneys to regulate water and sodium homeostasis. Therefore, the risk of dysnatremia increase with advanced stages of CKD. We investigated associations with serum sodium level measured at baseline with clinical outcomes in patients with end-stage renal disease (ESRD) initiating hemodialysis. Methods: This was a prospective cohort study based on the 1216 patients enrolled in the Clinical Research Center for End-Stage Renal Disease in Korea. The association of serum sodium level with all-cause mortality was examined in Cox models with adjustment for potential confounders. Results: During a median follow-up of 18.3 months, a total of 81 patients died. Patients with ≤135.9 mEq/L (n=371) had higher mortality when compared with patients with >136 mEq/L (n=845) (hazard ratio 2.041, p=0.001). In addition, patients with serum sodium levels of <130 (n=81), 130 to 135.9 (n=290) and >145 mEq/L (n=47) compared with 136 to 145 mEq/L (n=798) had unadjusted mortality hazard ratios of 2.920, 1.763 and 0.835 (p=0.001, p=0.025, and p=0.803). Furthermore, there were similar associations in models with incremental multivariable adjustments. Conclusions: These results show that hyponatremic patients at the initiation of hemodialysis therapy have higher mortality, indicating that serum sodium level may have prognostic value.
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