• Eur. J. Intern. Med. · Jun 2022

    Reconsidering the Edelman equation: impact of plasma sodium concentration, edema and body weight.

    • Jetta J Oppelaar, Mart D Vuurboom, Eliane F E Wenstedt, Frans J van Ittersum, L Vogt, and Olde EngberinkRik H GRHGAmsterdam UMC location University of Amsterdam, Department of Internal Medicine, Section of Nephrology, Meibergdreef 9, Amsterdam, The Netherlands; Amsterdam Cardiovascular Sciences, Microcirculation, Amsterdam, The Netherlands. El.
    • Amsterdam UMC location University of Amsterdam, Department of Internal Medicine, Section of Nephrology, Meibergdreef 9, Amsterdam, The Netherlands; Amsterdam Cardiovascular Sciences, Microcirculation, Amsterdam, The Netherlands.
    • Eur. J. Intern. Med. 2022 Jun 1; 100: 94-101.

    BackgroundGuidelines recommend treatment of dysnatremias to be guided by formulas based on the Edelman equation. This equation describes the relation between plasma sodium concentration and exchangeable cations. However, this formula does not take into account clinical parameters that have recently been associated with local tissue sodium accumulation, which occurs without concurrent water retention. We investigated to what extent such clinical factors affect the Edelman equation and dysnatremia treatment.MethodsWe performed a post-hoc analysis with original data of the Edelman study. Linear regression was used to examine the effect of age, sex, weight, edema, total body water (TBW) and heart and kidney failure on the Edelman equation. With attenuated correction, we corrected for measurement errors of both variables. Using piecewise regression, we analyzed whether the Edelman association differs for different plasma sodium concentrations.ResultsData was available for 82 patients; 57 males and 25 females with a mean (SD) age of 57 (15) years. The slope of the Edelman equation was significantly affected by weight (p=0.01) and edema (p=0.03). Also, below and above plasma sodium levels of 133 mmol/L the slope of the Edelman equation was significantly different (1.25 x0025vs 0.58x0025, p<0.01).ConclusionEdelman's equation's coefficients are significantly affected by weight, edema and plasma sodium, possibly reflecting differences in tissue sodium accumulation capacity. The performance of Edelman-based formulas in clinical settings may be improved by taking these clinical characteristics into account.Copyright © 2022. Published by Elsevier B.V.

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