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Impact of Hyponatremia after Renal Transplantation on Decline of Renal Function, Graft Loss and Patient Survival: A Prospective Cohort Study

Lena Berchtold, Anja Filzer, Rita Achermann, Vasileios Devetzis, Suzan Dahdal, Marco Bonani, Aurelia Schnyder, Dela Golshayan, Patrizia Amico, Uyen Huynh-Do, Sophie De Seigneux, Spyridon Arampatzis & On Behalf Of Swiss Transplant Cohort Study Collaborators

abstract

BACKGROUND
Hyponatremia is one of the most common electrolyte disorders observed in hospitalized and ambulatory patients. Hyponatremia is associated with increased falls, fractures, prolonged hospitalisation and mortality. The clinical importance of hyponatremia in the renal transplant field is not well established, so the aim of this study was to determine the relationships between hyponatremia and mortality as main outcome and renal function decline and graft loss as secondary outcome among a prospective cohort of renal transplant recipients.

METHODS
This prospective cohort study included 1315 patients between 1 May 2008 and 31 December 2014. Hyponatremia was defined as sodium concentration below 136 mmol/L at 6 months after transplantation. The main endpoint was mortality. A secondary composite endpoint was also defined as: rapid decline in renal function (≥5 mL/min/1.73 m drop of the eGFR/year), graft loss or mortality.

RESULTS
Mean sodium was 140 ± 3.08 mmol/L. 97 patients displayed hyponatremia with a mean of 132.9 ± 3.05 mmol/L. Hyponatremia at 6 months after transplantation was associated neither with mortality (HR: 1.02; = 0.97, 95% CI: 0.47-2.19), nor with the composite outcome defined as rapid decline in renal function, graft loss or mortality (logrank test = 0.9).

CONCLUSIONS
Hyponatremia 6 months after transplantation is not associated with mortality in kidney allograft patients.
   
citation Berchtold L, Filzer A, Achermann R, Devetzis V, Dahdal S, Bonani M, Schnyder A, Golshayan D, Amico P, Huynh-Do U, De Seigneux S, Arampatzis S, On Behalf Of Swiss Transplant Cohort Study Collaborators . Impact of Hyponatremia after Renal Transplantation on Decline of Renal Function, Graft Loss and Patient Survival: A Prospective Cohort Study. Nutrients 2021; 13:.
   
type journal paper/review (English)
date of publishing 27-08-2021
journal title Nutrients (13/9)
ISSN electronic 2072-6643
PubMed 34578871
DOI 10.3390/nu13092995