Association between serum sodium trajectory and mortality in patients with acute kidney injury: a retrospective cohort study

• Published in: BMC nephrology 2024-05, Vol.25 (1), p.152-152, Article 152
• Main Authors: Huang, Shanhe, Li, Xiaojing, Chen, Baorong, Zhong, Yaqi, Li, Yuewei, Huang, Tucheng
• Format: Article
• Language: English
• Subjects: Acute kidney injury; Acute Kidney Injury - blood; Acute Kidney Injury - mortality; Acute renal failure; Age composition; Aged; Analysis; Blood pressure; Cohort Studies; Cohort study; Data collection; Diabetes; Electrolyte metabolism; Female; Gender; Health aspects; Heart failure; Hospitals; Humans; Hypernatremia; Hypertension; Hyponatremia; Intensive care; Kaplan-Meier Estimate; Kidney diseases; Kidneys; Male; Medical advice systems; Medical prognosis; Medical research; Medicine, Experimental; Middle Aged; MIMIC database; Mortality; Patients; Prevention; Prognosis; Proportional Hazards Models; Retrospective Studies; Risk factors; Sepsis; Serum sodium trajectory; Sodium; Sodium - blood; Structured Query Language-SQL; Survival analysis; Vital signs
• ISSN: 1471-2369; 1471-2369
• DOI: 10.1186/s12882-024-03586-y

Dysnatremia is strongly associated with poor prognosis in acute kidney injury (AKI); however, the impact of sodium trajectories on the prognosis of patients with AKI has not yet been well elucidated. This study aimed to assess the association between sodium trajectories in patients with AKI and mortality at 30-day and 1-year follow-up. This retrospective cohort study used data from Medical Information Mart for Intensive Care (MIMIC)-IV database, and patients diagnosed with AKI within 48 h after admission were enrolled. Group-based trajectory models (GBTM) were applied to map the developmental course of the serum sodium fluctuations. Kaplan-Meier survival curve was used to compare differences in mortality in AKI patients with distinct serum sodium trajectories. Hazard ratios (HRs) were calculated to determine the association between trajectories and prognosis using Cox proportional hazard models. A total of 9,314 AKI patients were enrolled. Three distinct sodium trajectories were identified including: (i) stable group (ST, in which the serum sodium levels remained relatively stable, n = 4,935; 53.0%), (ii) descending group (DS, in which the serum sodium levels declined, n = 2,994; 32.15%) and (iii) ascending group (AS, in which the serum sodium levels were elevated, n = 1,383; 14.85%). There was no significant difference in age and gender distribution among the groups. The 30-day mortality rates were 7.9% in ST, 9.5% in DS and 16.6% in AS (p