| De novo Hyponatremia in Patients Undergoing Peritoneal Dialysis: A 12-month Observational Study |
| Hyun Hee Lee, M.D.1, 2*, Soo Jung Choi, M.D.1*, Heon Nam Lee, M.D.1 Sun Young Na, M.D.1, Jae Hyun Chang, M.D.1, 2 Wookyung Chung, M.D.1, 2, and Sejoong Kim, M.D.1, 2 |
Department of Internal Medicine1
Laboratory of Molecular Nephrology, 2 Gachon University of Medicine and Science, Incheon, Korea |
| 원저 : De novo Hyponatremia in Patients Undergoing Peritoneal Dialysis: A 12-month Observational Study |
| Hyun Hee Lee, M.D.1, 2*, Soo Jung Choi, M.D.1*, Heon Nam Lee, M.D.1 Sun Young Na, M.D.1, Jae Hyun Chang, M.D.1, 2 Wookyung Chung, M.D.1, 2, and Sejoong Kim, M.D.1, 2 |
| Department of Internal Medicine1, Laboratory of Molecular Nephrology, 2 Gachon University of Medicine and Science, Incheon, Korea |
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| Abstract |
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Purpose : Hyponatremia occurs infrequently in patients undergoing peritoneal dialysis (PD). Nevertheless, one must understand its pathophysiology, since the therapeutic strategy differs from that of non- PD-related hyponatremia. This study examined the clinical features of hyponatremia in PD and evaluated the factors that may contribute to its development.
Methods : We retrospectively enrolled 51 normonatremic PD patients at Gachon University Gil Hospital, South Korea. Using the plasma sodium levels at month 13, the patients were divided into hyponatremia (Na+ <135 mEq/L) and normonatremia (Na+ ≥135 mEq/L) groups. Then, the clinical variables of these patients were examined, including peritoneal function and adequacy tests, and biochemical parameters.
Results : The de novo hyponatremia (n=8) and normonatremia (n=43) groups had no significant differences in baseline characteristics. At month 1, the serum albumin was lower in the hyponatremia group (p=0.022). In the peritoneal equilibration test analysis, the dialysate-to-plasma ratio for creatinine (D/ PCr) measured after 13 months differed significantly between the two groups (p=0.007), while the maximum dip in sodium did not differ. No significant differences were observed in the normalized protein equivalent of nitrogen appearance, Kt/V, or residual renal function.
Conclusion : Our data suggest that the development of hyponatremia is associated with a lower initial serum albumin level and increased D/PCr in patients undergoing PD. Therefore, the serum sodium levels should be monitored more carefully in these patients. |
| Key Words:
Albumin, Hyponatremia, Peritoneal dialysis |
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