BibTex RIS Kaynak Göster

Assessment of adult patients with hypernatremia: A single center experience

Yıl 2015, Cilt: 42 Sayı: 3, 310 - 314, 24.10.2015
https://doi.org/10.5798/diclemedj.0921.2015.03.0580

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

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.

Hipernatremili erişkin hastaların değerlendirilmesi: Tek merkez deneyimi

Yıl 2015, Cilt: 42 Sayı: 3, 310 - 314, 24.10.2015
https://doi.org/10.5798/diclemedj.0921.2015.03.0580

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

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.
Toplam 19 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Bölüm Araştırma Yazıları
Yazarlar

Ercan Gündüz Bu kişi benim

Yılmaz Zengin Bu kişi benim

Mustafa İçer Bu kişi benim

Hasan Durgun Bu kişi benim

Recep Dursun Bu kişi benim

Ahmet Gündüzalp Bu kişi benim

Mustafa İpek Bu kişi benim

Cahfer Güloğlu Bu kişi benim

Yayımlanma Tarihi 24 Ekim 2015
Gönderilme Tarihi 24 Ekim 2015
Yayımlandığı Sayı Yıl 2015 Cilt: 42 Sayı: 3

Kaynak Göster

APA Gündüz, E., Zengin, Y., İçer, M., Durgun, H., vd. (2015). Assessment of adult patients with hypernatremia: A single center experience. Dicle Medical Journal, 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. Kasım 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, ve Cahfer Güloğlu. “Assessment of Adult Patients With Hypernatremia: A Single Center Experience”. Dicle Medical Journal 42, sy. 3 (Kasım 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 (01 Kasım 2015) Assessment of adult patients with hypernatremia: A single center experience. Dicle Medical Journal 42 3 310–314.
IEEE E. Gündüz, Y. Zengin, M. İçer, H. Durgun, R. Dursun, A. Gündüzalp, M. İpek, ve C. Güloğlu, “Assessment of adult patients with hypernatremia: A single center experience”, diclemedj, c. 42, sy. 3, ss. 310–314, 2015, doi: 10.5798/diclemedj.0921.2015.03.0580.
ISNAD Gündüz, Ercan vd. “Assessment of Adult Patients With Hypernatremia: A Single Center Experience”. Dicle Medical Journal 42/3 (Kasım 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 vd. “Assessment of Adult Patients With Hypernatremia: A Single Center Experience”. Dicle Medical Journal, c. 42, sy. 3, 2015, ss. 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.