Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association
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Nephrol. Dial. Transplant. · Mar 2012
ReviewSignificance of hypo- and hypernatremia in chronic kidney disease.
Both hypo- and hypernatremia are common conditions, especially in hospitalized patients and in patients with various comorbid conditions such as congestive heart failure or liver cirrhosis. Abnormal serum sodium levels have been associated with increased mortality in numerous observational studies. ⋯ To date, there has been a paucity of population-wide assessments of the incidence and prevalence of dysnatremias, their clinical characteristics and the outcomes associated with them in patients with various stages of CKD. We review the physiology and pathophysiology of water homeostasis with special emphasis on changes occurring in CKD, the outcomes associated with abnormal serum sodium in patients with normal kidney function and the results of recent studies in patients with various stages of CKD, which indicate a substantial incidence and prevalence and significant adverse outcomes associated with dysnatremias in this patient population.