Hyponatremia and Infection-related hospitalisation in ESRD patients undergoing maintenance hemodialysis: An observational study

Abstract

Background: Hyponatremia is one of the common dyselectrolytemia encountered in ESRD patients. Existing evidence suggests that hyponatremia contributes to the impairment of host immunity by interfering with the function of helper T-cells. This results in higher rate of infections among the patients undergoing maintenance hemodialysis. Objectives: To study the levels of serum sodium in ESRD patients undergoing maintenance hemodialysis and to establish the association between the severity of hyponatremia and infection-related hospitalisation in these patients. Methods: Study was conducted on 60 patients with ESRD undergoing maintenance hemodialysis thrice a week. Serum sodium was measured on admission and patients were categorized based on the severity of hyponatremia which was statistically correlated with infection-related hospitalisation. Results: Among the 60 patients studied, 87% were hospitalised with infections, among whom 50% had moderate and 50% had severe hyponatremia. The mean total leucocyte count was 16010±1295 cells/cubic mm, mean ESR was 80±12 mm/hour and mean CRP was 8.7±0.8 mg/L in the severe hyponatremia group which was higher than moderate and mild hyponatremia groups (p-value=0.0001, r-value: -0.746, -0.716 and -0.704 respectively). Conclusion: There was a significant negative correlation between serum sodium and infection risk in admitted patients as assessed by the total leucocyte count, ESR and CRP values. Serum sodium can be an independent marker for risk assessment and prediction of mortality in ESRD patients undergoing hemodialysis.

Key words: Hyponatremia, ESRD, Hemodialysis, Infection-related hospitalisation.