Öz
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
Anahtar Kelimeler
Kaynakça
- 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.
Öz
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
Anahtar Kelimeler
Kaynakça
- 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.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Bölüm | Araştırma Yazıları |
| Yazarlar | |
| Yayımlanma Tarihi | 24 Ekim 2015 |
| Gönderilme Tarihi | 24 Ekim 2015 |
| Yayımlandığı Sayı | Yıl 2015 Cilt: 42 Sayı: 3 |