Hyponatremia epidemiology and demographics
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Saeedeh Kowsarnia M.D.[2]
Overview
Hyponatremia is the most common electrolyte disorder. Its frequency is higher in females, elderly, and the patients who are hospitalized. The incidence of hyponatremia depends largely on the patient population which is a dependent of the underlying cause. A hospital incidence of 15–30% is common. Age over 30, female gender and lower body weights are risk factors for developing complications associated with hyponatremia.
Epidemiology and Demographics
Incidence
- Hyponatremia is the most common electrolyte disturbances in clinical practice, occurring in 15%-30% of hospitalized patients ( acutely or chronically) [1], 1-2% of this patients present with severe hyponatremia (serum sodium < 125 mEq/L) .
- Post-operative hyponatremia develops in 4.4% of patients within 1st week of surgery [2] .
Prevalence
- Prevalence of hyponatremia is 1720 per 100,000 in the U.S. population [3] .
- Nearly 7.7 % of patients who are visited in outpatients clinics are hyponatremic.
- Hyponatremia is seen in up to 27% of patients with heart failure (HF) [4] .
- Approximately 50% of patients with cirrhosis and ascites are found to be hyponatremic [5] .
- Hyponatremia has been reported in up to 30% of elderly patients in nursing homes and is also present in approximately 30% of depressed patients on selective serotonin reuptake inhibitors [6] .
Case-fatality rate/Mortality rate
- Over the period of 1999-2006, mortality rate was 11% and 4% for hyponatremic and normonatremia subjects, respectively [7] .
- There is an increased risk of mortality in patients with congestive heart failure, renal failure and cirrhosis.
- Hyponatremia is associated with worse clinical outcome, inpatients or outpatients.
- The underlying illness that is associated with hyponatremia has more correlation with mortality rate rather than severity of hyponatremia [8].
Age
- Age over 30 is related to increased overall incident of hyponatremia especially hospital acquired hyponatremia. The association is stronger even with increasing severity of hyponatremia [9] .
- In elderly patients, lower body weight is associated with increased risk of drug-induced hyponatremia [10] .
Gender
- Female sex is considered a risk factor for psychotropic and diuretic-induced hyponatremia [11] .
- Severe hyponatremia occurs more frequently in women because of lower body weight.
References
- ↑ Upadhyay, Ashish; Jaber, Bertrand L.; Madias, Nicolaos E. (2006). "Incidence and Prevalence of Hyponatremia". The American Journal of Medicine. 119 (7): S30–S35. doi:10.1016/j.amjmed.2006.05.005. ISSN 0002-9343.
- ↑ Upadhyay, Ashish; Jaber, Bertrand L.; Madias, Nicolaos E. (2006). "Incidence and Prevalence of Hyponatremia". The American Journal of Medicine. 119 (7): S30–S35. doi:10.1016/j.amjmed.2006.05.005. ISSN 0002-9343.
- ↑ Mohan, Sumit; Gu, Sue; Parikh, Amay; Radhakrishnan, Jai (2013). "Prevalence of Hyponatremia and Association with Mortality: Results from NHANES". The American Journal of Medicine. 126 (12): 1127–1137.e1. doi:10.1016/j.amjmed.2013.07.021. ISSN 0002-9343.
- ↑ Bettari, Luca; Fiuzat, Mona; Shaw, Linda K.; Wojdyla, Daniel M.; Metra, Marco; Felker, G. Michael; O’Connor, Christopher M. (2012). "Hyponatremia and Long-Term Outcomes in Chronic Heart Failure—An Observational Study From the Duke Databank for Cardiovascular Diseases". Journal of Cardiac Failure. 18 (1): 74–81. doi:10.1016/j.cardfail.2011.09.005. ISSN 1071-9164.
- ↑ Angeli, Paolo; Wong, Florence; Watson, Hugh; Ginès, Pere (2006). "Hyponatremia in cirrhosis: Results of a patient population survey". Hepatology. 44 (6): 1535–1542. doi:10.1002/hep.21412. ISSN 0270-9139.
- ↑ Schrier, Robert W. "Does 'asymptomatic hyponatremia' exist?" Nature Reviews Nephrology. Vol 6, Apr 2010; p 185.
- ↑ Mohan, Sumit; Gu, Sue; Parikh, Amay; Radhakrishnan, Jai (2013). "Prevalence of Hyponatremia and Association with Mortality: Results from NHANES". The American Journal of Medicine. 126 (12): 1127–1137.e1. doi:10.1016/j.amjmed.2013.07.021. ISSN 0002-9343.
- ↑ Hoorn, E. J.; Zietse, R. (2011). "Hyponatremia and Mortality: How Innocent is the Bystander?". Clinical Journal of the American Society of Nephrology. 6 (5): 951–953. doi:10.2215/CJN.01210211. ISSN 1555-9041.
- ↑ Upadhyay, Ashish; Jaber, Bertrand L.; Madias, Nicolaos E. (2006). "Incidence and Prevalence of Hyponatremia". The American Journal of Medicine. 119 (7): S30–S35. doi:10.1016/j.amjmed.2006.05.005. ISSN 0002-9343.
- ↑ Upadhyay, Ashish; Jaber, Bertrand L.; Madias, Nicolaos E. (2006). "Incidence and Prevalence of Hyponatremia". The American Journal of Medicine. 119 (7): S30–S35. doi:10.1016/j.amjmed.2006.05.005. ISSN 0002-9343.
- ↑ Upadhyay, Ashish; Jaber, Bertrand L.; Madias, Nicolaos E. (2006). "Incidence and Prevalence of Hyponatremia". The American Journal of Medicine. 119 (7): S30–S35. doi:10.1016/j.amjmed.2006.05.005. ISSN 0002-9343.