ABSTRACT
Objective To investigate the effect of different serum sodium levels on heart function and prognosis in very elderly patients with heart failure. Methods Totally 152 elderly patients(aged ≥ 85 years)with hyponatremia were enrolled.Based on the serum sodium level ,they were divided into mild(125 mmol/L ≤ Na+ < 135 mmol/L) ,moderate(125 mmol/L ≤ Na+ < 135 mmol/L) ,and severe hyponatremia(Na+ < 115 mmol/L)groups ,and 76 patients with normal blood sodium level(Na+ ≥ 135 mmol/L)were selected as control group. The general data ,levels of serum creatinine and N-terminal pro-brain natriuretic peptide (NTproBNP)and prognosis were compared among the above groups. Results Compared with the control group ,patients with severe hyponatremia were much older ,with more diuretics administration ,higher level of serum creatinine , lowerlevelofeGFRandleftventricularejectionfractions[(38.1±3.9)％ vs.(45.2±9.7)％ ].There were higher incidences of coronary atherosclerotic heart disease [72.4％ (n=21)vs. 56.6％ (n=43)] ,diabetes[41.4％ (n=12)vs. 23.7％ (n=18)] ,chronic renal insufficiency [22.6％ (n=8)vs. 11.8％ (n=9)] ,stroke[20.6％ (n=6)vs. 9.2％ (n=7)]in patients with severe hyponatremia compared with other groups. The severe hyponatremia group showed significantly higher levels of NTproBNP [(4823. 9 ± 588. 1 )ng/L v s. (1124. 4 ± 349. 1 )ng/L ,(1836. 2 ± 369. 3 )ng/L ,(2894. 1 ± 687. 3 )ng/L ]and higher rates of mortality [27.6％ (n=8) vs.5.3％ (n=4) ,7.6％ (n=6) ,13.6％ (n=6)]as compared to the control group ,mild and moderate hyponatremia groups. Furthermore ,length of stay in hospital were markedly longer in patients with severe hyponatremia than those with mild and moderate hyponatremia[(11.1 ± 7.1)d vs. (19.6 ± 5.7)d ,(16.1 ± 4.2)d] . Conclusions Hyponatremia is a common type of electrolyte disorder in very elderly patients with heart failure ,and severe hyponatremia may predictand increased risk of death.
ABSTRACT
Objective To survey a prevalence of osteoporosis and prevalence of osteoporosis combined with hyponatremia in elderly hospitalized patients,and their risk factors.Methods We enrolled 2496 elderly hospitalized patients with detected plasma levels of sodium,calcium,25 (OH) D3,PTH,plasma PINP,and β-CTX.At the same time,sex,age,height,weight,smoking history,drinking history and BMI(kg/m2) in form of a questionnaire were recorded and calculated.The risk factors for osteoporosis were analyzed using multivariate Logistic regression method.Results The osteoporosis prevalence was 12.2％ (305/2496 inpatients)with 31.5 ％ (96/305)in male,68.5％ (209/305)in female(x2 =4.651,P=0.031).The prevalence of osteoporosis with hyponatremia was 27.5 ％ (84/305),with 24.8 ％ (21/84) in male and 75.2 ％ (63/84) in female(x2 =9.251,P=0.025).As compared with three groups of non-osteoporosis,normal serum Na+ with and without osteoporosis,the osteoporosis patients with hyponatremia were more aged,in a higher proportion of women and smokers,in lower BMI,and in low levels of serum sodium,BMD 25(OH)D3 (F=13.783,0.861,7.146,24.520,0.548,x2 =15.113、4.472;P =0.001,0.000,0.021,0.015,0.003,0.021,0.005).Multivariate Logistic regression analysis showed that aging,female,low BMI,smoking history,drinking history,low plasma 25(OH)D3 level,low plasma PINP level,and high plasma β-CTX level were the risk factors for osteoporosis(OR 4.215,2.271,3.176,2.013,1.237,3.987,1.843,1.972;all P＜0.05).Conclusions The osteoporosis prevalence is high in elderly patients,especially in old women.The risk factors for osteoporosis are diverse,and clinical conditions of osteoporosis patients with hyponatremia are much more severe than the others.More efforts should be given to them and need to be focused on the complications of osteoporosis.
ABSTRACT
Objective To investigate the sodium and potassium disturbances in 9870 elderly inpatients and to analyze their risk factors.Methods Clinical data of sodium and potassium levels and the possible risk factors were collected in the elderly inpatients from a single center.The incidence of sodium and potassium disturbances and their risk factors were analyzed by multiple Logistic regression,and the correction of the imbalance was investigated.Results A total of 6027(61.6％)times of sodium and potassium disturbances were found in the 9870 elderly inpatients on admission and during hospitalization,and the total incidence of this disturbances was 61.6％.The incidences of hyponatremia,hypokalemia,hypernatremia and hyperkalemia were 27.9％ (2729/6027),9.7％ (951/6027),15.4％(1506/6027) and 8.6％ (841/6027),respectively.Heart failure was the common risk factor for the two electrolyte disturbances.T2DM caused hyponatremia,hypokalemia and hypernatremia.Among the medication risk factors,diuretics were the common risk factor for various electrolyte disturbances.Patients taking antiepileptics,antidementia drugs,antidepressants and benzodiazepines were more likely to have hyponatremia.The correction rate of mild,moderate and severe hyponatremia/ hypokalemia were 79.2％(1253/1582),68.1％ (535/786),45.1％ (163/361) and 79.5％(776/976),66.4％(217/327),40.1％(81/203),respectively.The time for the correction of the above degrees of hyponatremia/ hypokalemia were(3.7±2.7) d,(4.1±2.3) d,(8.9±1.6) d and(2.5± 1.4) d,(3.2 ± 1.5) d,(6.1 ± 1.2) d.The supplement amounts of sodium chloride and potassium chloride were(5.98±3.67) g,(9.45±3.02) g,(10.26±1.32) g and(2.23±0.93) g,(5.12± 1.53) g,(8.07 ± 2.46) g,respectively.Conclusions The incidences of electrolyte disturbances are high in elderly inpatients with combined diseases and application of various drugs,and the correction of disturbances is difficult.More attention should be paid to the electrolyte disturbances,which should be corrected positively.