De novo Hyponatremia in Patients Undergoing Peritoneal Dialysis: A 12-month Observational Study

• Published in: Kidney research and clinical practice pp. 31 - 37
• Main Authors: 이현희, 최수정, 이헌남, 나선영, 장제현, 정우경, 김세중
• Format: Journal Article
• Language: English
• Published: 대한신장학회 01.01.2010
• Subjects: 내과학
• ISSN: 2211-9132; 2211-9140

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. KCI Citation Count: 0