Hyponatremia is the most common electrolyte disorder worldwide, with a prevalence ranging from 14.5% to 58% in hospitalized patients without kidney disease. Hospitalized patients with hyponatremia have a 50% higher risk of death compared with patients with eunatremia. Hyponatremia may contribute to increased mortality secondary to organ dysfunction. The presence of hyponatremia has been associated with more deleterious outcomes in congestive heart failure (CHF) and cirrhosis. Hypernatremia is less common with a reported prevalence of 2% in hospitalized patients. Hypernatremia is an independent risk factor for mortality, particularly in the intensive care unit. The kidneys play a central role in the regulation of water homeostasis.

 Dysregulation in electrolyte-free water balance predisposes individuals with kidney disease to dysnatremias. In advanced chronic kidney disease (CKD), the kidneys lose their ability to concentrate and/or dilute urine, which may predispose individuals to hypernatremia and hyponatremia, respectively. Dysnatremias in patients with CKD have been associated with increased all-cause mortality, cardiovascular, malignancy, and non-cardiovascular/non-malignancy-related deaths. Individuals with CKD at risk for hyponatremia include those with younger age, diabetes, CHF, and earlier stages of CKD. There is a void of literature on the long-term effects of sodium in an extensively studied CKD population, and therefore, we sought to evaluate the effect of dysnatremias on mortality and kidney failure from patients enrolled in the Chronic Renal Insufficiency Cohort (CRIC) study.

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Mishita
Jornal co-ordinator
Journal of Clinical & Experimental Nephrology