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Moderate/Severe hyponatremia increases the risk of death among hospitalized Chinese human immunodeficiency virus/acquired immunodeficiency syndrome patients.

Xu L, Ye H, Huang F, Yang Z, Zhu B, Xu Y, Qiu Y, Li L - PLoS ONE (2014)

Bottom Line: The Kaplan-Meier method and the Cox proportional hazards model were used to analyze the effect of different serum sodium levels on survival.Only moderate/severe hyponatremia affects the prognosis of Chinese HIV/AIDS patients.Earlier intensive medical managements(including HAART)are necessary to increase the survival rates of Chinese HIV/AIDS patients with moderate/severe hyponatremia.

View Article: PubMed Central - PubMed

Affiliation: The State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou City, China; Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou City, China.

ABSTRACT

Objectives: To evaluate whether the serum sodium concentration is associated with the progression and long-term prognosis of Chinese HIV/AIDS patients.

Methods: Three hundred and eighty seven hospitalized patients were recruited into this retrospective cohort study. The strata of serum sodium concentration were moderate/severe hyponatremia, mild hyponatremia and normonatremia. Disease progression was estimated using CD4 counts and the WHO clinical stage. Correlation analysis was used to evaluate the serum sodium concentration with disease progression. The Kaplan-Meier method and the Cox proportional hazards model were used to analyze the effect of different serum sodium levels on survival.

Results: In this study 206 patients (53.2%) had hyponatremia, including 10.6% patients with moderate/severe hyponatremia and 42.6% with mild hyponatremia. The serum sodium concentration was significantly correlated with the HIV/AIDS progression (P<0.001). During the follow-up, 100 patients (25.6%) died. The cumulative survival rates of HIV/AIDS patients were 47.8% ± 8.5% in patients with moderate/severe hyponatremia, 59.8% ± 5.0% with mild hyponatremia and 79.9% ± 3.4% with normonatremia (log-rank P<0.001). After adjusting for sex, age, WHO stage, CD4 count, hemoglobin and albumin, the relative hazard was 3.5 (95% CI: 1.9-6.5) for patients with moderate/severe hyponatremia (P<0.001), and 1.5 (95% CI: 0.9-2.4) for those with mild hyponatremia (P = 0.161), compared with normonatremic patients.

Conclusions: The serum sodium level is closely correlated with the severity of patients. Only moderate/severe hyponatremia affects the prognosis of Chinese HIV/AIDS patients. Earlier intensive medical managements(including HAART)are necessary to increase the survival rates of Chinese HIV/AIDS patients with moderate/severe hyponatremia.

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Related in: MedlinePlus

Mean serum sodium concentration in patients according to CD4 count and WHO stage.Serum sodium concentration decreases with a reduction in CD4 count and an increases with WHO stage (F = 7.004, P<0.001).
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pone-0111077-g001: Mean serum sodium concentration in patients according to CD4 count and WHO stage.Serum sodium concentration decreases with a reduction in CD4 count and an increases with WHO stage (F = 7.004, P<0.001).

Mentions: Furthermore, the progression of disease was evaluated together with the WHO stage and CD4 level, our research illustrated patients in advanced WHO stages and with a lower CD4 count had a lower serum sodium concentration, while the patients in the primary WHO stage and with a higher CD4 count had higher serum sodium concentration (F = 7.004, P<0.001) (Figure 1).


Moderate/Severe hyponatremia increases the risk of death among hospitalized Chinese human immunodeficiency virus/acquired immunodeficiency syndrome patients.

Xu L, Ye H, Huang F, Yang Z, Zhu B, Xu Y, Qiu Y, Li L - PLoS ONE (2014)

Mean serum sodium concentration in patients according to CD4 count and WHO stage.Serum sodium concentration decreases with a reduction in CD4 count and an increases with WHO stage (F = 7.004, P<0.001).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4215865&req=5

pone-0111077-g001: Mean serum sodium concentration in patients according to CD4 count and WHO stage.Serum sodium concentration decreases with a reduction in CD4 count and an increases with WHO stage (F = 7.004, P<0.001).
Mentions: Furthermore, the progression of disease was evaluated together with the WHO stage and CD4 level, our research illustrated patients in advanced WHO stages and with a lower CD4 count had a lower serum sodium concentration, while the patients in the primary WHO stage and with a higher CD4 count had higher serum sodium concentration (F = 7.004, P<0.001) (Figure 1).

Bottom Line: The Kaplan-Meier method and the Cox proportional hazards model were used to analyze the effect of different serum sodium levels on survival.Only moderate/severe hyponatremia affects the prognosis of Chinese HIV/AIDS patients.Earlier intensive medical managements(including HAART)are necessary to increase the survival rates of Chinese HIV/AIDS patients with moderate/severe hyponatremia.

View Article: PubMed Central - PubMed

Affiliation: The State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou City, China; Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou City, China.

ABSTRACT

Objectives: To evaluate whether the serum sodium concentration is associated with the progression and long-term prognosis of Chinese HIV/AIDS patients.

Methods: Three hundred and eighty seven hospitalized patients were recruited into this retrospective cohort study. The strata of serum sodium concentration were moderate/severe hyponatremia, mild hyponatremia and normonatremia. Disease progression was estimated using CD4 counts and the WHO clinical stage. Correlation analysis was used to evaluate the serum sodium concentration with disease progression. The Kaplan-Meier method and the Cox proportional hazards model were used to analyze the effect of different serum sodium levels on survival.

Results: In this study 206 patients (53.2%) had hyponatremia, including 10.6% patients with moderate/severe hyponatremia and 42.6% with mild hyponatremia. The serum sodium concentration was significantly correlated with the HIV/AIDS progression (P<0.001). During the follow-up, 100 patients (25.6%) died. The cumulative survival rates of HIV/AIDS patients were 47.8% ± 8.5% in patients with moderate/severe hyponatremia, 59.8% ± 5.0% with mild hyponatremia and 79.9% ± 3.4% with normonatremia (log-rank P<0.001). After adjusting for sex, age, WHO stage, CD4 count, hemoglobin and albumin, the relative hazard was 3.5 (95% CI: 1.9-6.5) for patients with moderate/severe hyponatremia (P<0.001), and 1.5 (95% CI: 0.9-2.4) for those with mild hyponatremia (P = 0.161), compared with normonatremic patients.

Conclusions: The serum sodium level is closely correlated with the severity of patients. Only moderate/severe hyponatremia affects the prognosis of Chinese HIV/AIDS patients. Earlier intensive medical managements(including HAART)are necessary to increase the survival rates of Chinese HIV/AIDS patients with moderate/severe hyponatremia.

Show MeSH
Related in: MedlinePlus