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Assessment of adult patients with hypernatremia: A single center experience

Year 2015, Volume: 42 Issue: 3, 310 - 314, 24.10.2015
https://doi.org/10.5798/diclemedj.0921.2015.03.0580

Abstract

Objective: In the present study, determination of symptoms, clinical characteristics, prevalence and recovery rates was aimed in patients who applied to the emergency service and diagnosed with hypernatremia.

Methods: Patients who applied to Dicle University Medical School Emergency Service during January 2013-December 2014 and whose serum Na>148 mEq/L were included in the study. The study was conducted retrospectively.

Results: Hypernatremia prevalence was determined as 0.21% in the cases who applied to the emergency service. The average age in all patients was 69±22 and the median age was 72 years. The average hospitalization period was 13.3±10.9 days. The mortality rate was 75.7% and male gender domination (56%) was determined in patients who developed mortality. When mortality and recovery groups were compared statistically; significant difference was determined (p<0.05) in terms of hospitalization period, glucose, urea, creatinine and calcium averages. The complaints of our patients who applied to the emergency service were changes in consciousness (92.7%), oral intake disorder (83.4%) and fever (48.6%) based on frequency order. The accompanying comorbid states were cerebrovascular illness (36.9%), Dementia/Alzheimer (32.4%) and hypertension (28.9%) based on frequency order.

Conclusion: Consequently, hypernatremia is a fluid-electrolyte disorder progressing with high mortality and could be observed in older patients and in patients whose oral intake is defective and who have cerebrovascular illness and dementia.

Key words: Hypernatremia, prevalence, mortality

References

  • Liamis G, Tsimihodimos V, Doumas M, et al. Clinical and laboratory characteristics of hypernatraemia in an internal medicine clinic. Nephrol Dial Transplant 2008;23:136-143.
  • Palevsky PM, Bhagrath R, Greenberg A, et al. Hypernatremia in hospitalized patients. Ann Intern Med 1996;124:197-203.
  • Aiyagari V, Deibert E, Diringer MN, et al. Hypernatremia in the neurologic intensive care unit: How high is too high? J Crit Care 2006;21:163-172.
  • Tayman C, Tanbul A, Aydemir S, et al. Anne sütüne bağlı hipernatremik dehidratasyonun klinik bulguları ve tedavi önerileri. Dicle Tıp Dergisi 2010;37:254-262.
  • Adrogue HJ, Madias NE. Hypernatremia. N Engl J Med 2000;342:1493-1499.
  • Brenner B, Singer G. Fluid and electrolyte disturbances. In: Kasper D, Braunwald E, Fauci A, et al, eds. Harrison’s principles of internal edicine. 16th ed. New York: Mc-GrawHill;2005:251–263.
  • Yucel N, Sahin I, Akgun FS, et al. Hypernatremia in The Emergency Department .Turk Neph Dial Transpl 2012;21:124-129.
  • Çağlar Ş, Süleymanlar G, Ecder T, et al. Sıvı, elektrolit ve asit-baz dengesi bozuklukları. İç Hastalıkları. Ankara Güneş Kitabevi, 2003;1251-1285.
  • Verbalis JG. Disorders of body water homeostasis. Best Pract Res Clin Endocrinol Metab 2003;17:471–503.
  • Palevsky PM. Hypernatremia. In: Greenberg A, Cheung A,Coffman T, et al, eds. Primer on kidney diseases. 4th ed.Philadelphia: Elsevier Saunders; 2005:58–65.
  • Parikh C, Berl T. Disorders of water metabolism. In: Feehally J, Floege J, Johnson R, eds. Comprehensive clinical nephrology. 3rd ed. Philadelphia: Mosby Elsevier;2007:93–110.
  • Liamis G, Milionis HJ, Elisaf M, et al. A review of druginduced hypernatremia. NDT Plus 2009;2:339-346.
  • Mandal AK, Saklayen MG, Hillman NM, et al. Predictive factors for high mortality in hypernatremic patients. Am J Emerg Med 1997;15:130-132.
  • Fried LF, Palevsky PM, et al. Hyponatremia and hypernatremia.
  • Med Clin North Am 1997;81:585-609.
  • O’hare AM, Bertenthal D, Covinsky KE, et al. Mortality risk stratification in chronic kidney disease: one size for all ages? J Am Soc Nephrol 2006;34:126-132.
  • Ismail N, Becker BN. Treatment options and strategies in uremia: current trends and future directions. Semin Nephrol 1994; 14:292-299.
  • Borra SI, Beredo R, Kleinfeld M, et al. Hypernatremia in the aging. J Natl Med Assoc 1995;87:220-224.
  • Achinger SV, Moritz ML, Ayus JC: Dysnatremias: Why are patients still dying? South Med J 2006;99:353-362.

Hipernatremili erişkin hastaların değerlendirilmesi: Tek merkez deneyimi

Year 2015, Volume: 42 Issue: 3, 310 - 314, 24.10.2015
https://doi.org/10.5798/diclemedj.0921.2015.03.0580

Abstract

Amaç: Bu çalışmada acil servise başvuran ve hipernatremi tespit edilen hastalarda semptomlar, klinik özellikler, prevalans ve sağ-kalım oranlarının belirlenmesi amaçlanmıştır. Yöntemler: Çalışmaya, Ocak 2013-Aralık 2014 tarihleri arasında Dicle Üniversitesi Tıp Fakültesi acil servisine başvuran, serum Na>148 mEq/L üzerinde olan hastalar dahil edildi. Çalışma retrospektif olarak gerçekleştirildi. Bulgular: Acil servise başvuran olgularda hipernatremi prevalansı %0,21 olarak tespit edildi. Tüm hastaların yaş ortalaması 69±22, median yaş 72 yıl idi. Ortalama hastanede kalma süresi 13,3±10,9 gün idi. Mortalite oranı %75,7 ve mortalite gelişen hastalarda erkek cinsiyet hakimiyeti (%56) tespit edildi. Mortalite ile şifa grubu istatistiksel olarak karşılaştırıldığında; hastanede kalma süresi, glukoz, üre, kreatinin ve kalsiyum ortalamaları açısından anlamlı fark tespit edildi (p< 0.05). Hastalarımızın acil servise başvuru yakınmaları sıklık sırasına göre bilinç değişikliği (%92,7), oral alım bozukluğu (%82,4), ateş (%48,6) idi. Eşlik eden komorbid durumlar ise sıklık sırasına göre serebrovasküler hastalık (%36,9), Demans/Alzheimer (%32,4), Hipertansiyon (%28,9) idi. Sonuç: Sonuç olarak hipernatremi yaşlı, oral alımı bozuk, serebrovasküler hastalığı ve demansı olanlarda daha sık görülebilen ve yüksek mortaliteyle seyreden bir sıvı-elektrolit bozukluğudur

References

  • Liamis G, Tsimihodimos V, Doumas M, et al. Clinical and laboratory characteristics of hypernatraemia in an internal medicine clinic. Nephrol Dial Transplant 2008;23:136-143.
  • Palevsky PM, Bhagrath R, Greenberg A, et al. Hypernatremia in hospitalized patients. Ann Intern Med 1996;124:197-203.
  • Aiyagari V, Deibert E, Diringer MN, et al. Hypernatremia in the neurologic intensive care unit: How high is too high? J Crit Care 2006;21:163-172.
  • Tayman C, Tanbul A, Aydemir S, et al. Anne sütüne bağlı hipernatremik dehidratasyonun klinik bulguları ve tedavi önerileri. Dicle Tıp Dergisi 2010;37:254-262.
  • Adrogue HJ, Madias NE. Hypernatremia. N Engl J Med 2000;342:1493-1499.
  • Brenner B, Singer G. Fluid and electrolyte disturbances. In: Kasper D, Braunwald E, Fauci A, et al, eds. Harrison’s principles of internal edicine. 16th ed. New York: Mc-GrawHill;2005:251–263.
  • Yucel N, Sahin I, Akgun FS, et al. Hypernatremia in The Emergency Department .Turk Neph Dial Transpl 2012;21:124-129.
  • Çağlar Ş, Süleymanlar G, Ecder T, et al. Sıvı, elektrolit ve asit-baz dengesi bozuklukları. İç Hastalıkları. Ankara Güneş Kitabevi, 2003;1251-1285.
  • Verbalis JG. Disorders of body water homeostasis. Best Pract Res Clin Endocrinol Metab 2003;17:471–503.
  • Palevsky PM. Hypernatremia. In: Greenberg A, Cheung A,Coffman T, et al, eds. Primer on kidney diseases. 4th ed.Philadelphia: Elsevier Saunders; 2005:58–65.
  • Parikh C, Berl T. Disorders of water metabolism. In: Feehally J, Floege J, Johnson R, eds. Comprehensive clinical nephrology. 3rd ed. Philadelphia: Mosby Elsevier;2007:93–110.
  • Liamis G, Milionis HJ, Elisaf M, et al. A review of druginduced hypernatremia. NDT Plus 2009;2:339-346.
  • Mandal AK, Saklayen MG, Hillman NM, et al. Predictive factors for high mortality in hypernatremic patients. Am J Emerg Med 1997;15:130-132.
  • Fried LF, Palevsky PM, et al. Hyponatremia and hypernatremia.
  • Med Clin North Am 1997;81:585-609.
  • O’hare AM, Bertenthal D, Covinsky KE, et al. Mortality risk stratification in chronic kidney disease: one size for all ages? J Am Soc Nephrol 2006;34:126-132.
  • Ismail N, Becker BN. Treatment options and strategies in uremia: current trends and future directions. Semin Nephrol 1994; 14:292-299.
  • Borra SI, Beredo R, Kleinfeld M, et al. Hypernatremia in the aging. J Natl Med Assoc 1995;87:220-224.
  • Achinger SV, Moritz ML, Ayus JC: Dysnatremias: Why are patients still dying? South Med J 2006;99:353-362.
There are 19 citations in total.

Details

Primary Language English
Journal Section Research Articles
Authors

Ercan Gündüz This is me

Yılmaz Zengin This is me

Mustafa İçer This is me

Hasan Durgun This is me

Recep Dursun This is me

Ahmet Gündüzalp This is me

Mustafa İpek This is me

Cahfer Güloğlu This is me

Publication Date October 24, 2015
Submission Date October 24, 2015
Published in Issue Year 2015 Volume: 42 Issue: 3

Cite

APA Gündüz, E., Zengin, Y., İçer, M., Durgun, H., et al. (2015). Assessment of adult patients with hypernatremia: A single center experience. Dicle Tıp Dergisi, 42(3), 310-314. https://doi.org/10.5798/diclemedj.0921.2015.03.0580
AMA Gündüz E, Zengin Y, İçer M, Durgun H, Dursun R, Gündüzalp A, İpek M, Güloğlu C. Assessment of adult patients with hypernatremia: A single center experience. diclemedj. November 2015;42(3):310-314. doi:10.5798/diclemedj.0921.2015.03.0580
Chicago Gündüz, Ercan, Yılmaz Zengin, Mustafa İçer, Hasan Durgun, Recep Dursun, Ahmet Gündüzalp, Mustafa İpek, and Cahfer Güloğlu. “Assessment of Adult Patients With Hypernatremia: A Single Center Experience”. Dicle Tıp Dergisi 42, no. 3 (November 2015): 310-14. https://doi.org/10.5798/diclemedj.0921.2015.03.0580.
EndNote Gündüz E, Zengin Y, İçer M, Durgun H, Dursun R, Gündüzalp A, İpek M, Güloğlu C (November 1, 2015) Assessment of adult patients with hypernatremia: A single center experience. Dicle Tıp Dergisi 42 3 310–314.
IEEE E. Gündüz, “Assessment of adult patients with hypernatremia: A single center experience”, diclemedj, vol. 42, no. 3, pp. 310–314, 2015, doi: 10.5798/diclemedj.0921.2015.03.0580.
ISNAD Gündüz, Ercan et al. “Assessment of Adult Patients With Hypernatremia: A Single Center Experience”. Dicle Tıp Dergisi 42/3 (November 2015), 310-314. https://doi.org/10.5798/diclemedj.0921.2015.03.0580.
JAMA Gündüz E, Zengin Y, İçer M, Durgun H, Dursun R, Gündüzalp A, İpek M, Güloğlu C. Assessment of adult patients with hypernatremia: A single center experience. diclemedj. 2015;42:310–314.
MLA Gündüz, Ercan et al. “Assessment of Adult Patients With Hypernatremia: A Single Center Experience”. Dicle Tıp Dergisi, vol. 42, no. 3, 2015, pp. 310-4, doi:10.5798/diclemedj.0921.2015.03.0580.
Vancouver Gündüz E, Zengin Y, İçer M, Durgun H, Dursun R, Gündüzalp A, İpek M, Güloğlu C. Assessment of adult patients with hypernatremia: A single center experience. diclemedj. 2015;42(3):310-4.