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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

Kaplan–Meier survival curves according to serum sodium concentration.The serum sodium level affects mainly the 3-year mortality rate of patients. The 3-year cumulative survival rates for patients with moderate/severe and mild hyponatremia were 47.8%±8.5% and 59.8%±5.0%, respectively, and 78.2%±3.8% for normonatremic patients (Log-Rank, P<0.001).
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pone-0111077-g002: Kaplan–Meier survival curves according to serum sodium concentration.The serum sodium level affects mainly the 3-year mortality rate of patients. The 3-year cumulative survival rates for patients with moderate/severe and mild hyponatremia were 47.8%±8.5% and 59.8%±5.0%, respectively, and 78.2%±3.8% for normonatremic patients (Log-Rank, P<0.001).

Mentions: The effect of serum sodium concentration on the long-term survival of patients was determined. During the follow-up time, 100 (25.8%) patients died, including 19 patients with moderate/severe hyponatremia, 49 with mild hyponatremia, and 32 with normonatremia. Of these, 86 patients (86.0%) died within 6 months of initial follow-up, eight (8.0%) died within 6–12 months, 3 (3.0%) died within 18–24 months, and three (3.0%) died within 24–36 months. Kaplan–Meier analysis indicated the 3-year cumulative survival rates were 47.8%±8.5% for patients with moderate/severe hyponatremia, 59.8%±5.0% for those with mild hyponatremia and 78.2%±3.8% for normonatremic patients (Log-Rank, P<0.001) (Figure 2).


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)

Kaplan–Meier survival curves according to serum sodium concentration.The serum sodium level affects mainly the 3-year mortality rate of patients. The 3-year cumulative survival rates for patients with moderate/severe and mild hyponatremia were 47.8%±8.5% and 59.8%±5.0%, respectively, and 78.2%±3.8% for normonatremic patients (Log-Rank, P<0.001).
© Copyright Policy
Related In: Results  -  Collection

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

pone-0111077-g002: Kaplan–Meier survival curves according to serum sodium concentration.The serum sodium level affects mainly the 3-year mortality rate of patients. The 3-year cumulative survival rates for patients with moderate/severe and mild hyponatremia were 47.8%±8.5% and 59.8%±5.0%, respectively, and 78.2%±3.8% for normonatremic patients (Log-Rank, P<0.001).
Mentions: The effect of serum sodium concentration on the long-term survival of patients was determined. During the follow-up time, 100 (25.8%) patients died, including 19 patients with moderate/severe hyponatremia, 49 with mild hyponatremia, and 32 with normonatremia. Of these, 86 patients (86.0%) died within 6 months of initial follow-up, eight (8.0%) died within 6–12 months, 3 (3.0%) died within 18–24 months, and three (3.0%) died within 24–36 months. Kaplan–Meier analysis indicated the 3-year cumulative survival rates were 47.8%±8.5% for patients with moderate/severe hyponatremia, 59.8%±5.0% for those with mild hyponatremia and 78.2%±3.8% for normonatremic patients (Log-Rank, P<0.001) (Figure 2).

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