Natraemia variations induced by acute dialysis in critically ill patients: a database study
Abstract Natraemia is often abnormal in critically ill patients and may change rapidly during renal replacement therapy (RRT). This database study in a single intensive care unit (ICU) evaluated natraemia before and after the first RRT session for acute kidney injury. Of 252 patients who required RR...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Nature Portfolio
2022-09-01
|
| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-022-18897-z |
| _version_ | 1811274910818893824 |
|---|---|
| author | Gilles Troché Virginie Laurent Alexis Ferré Gwenaelle Jacq Marine Paul Sybille Merceron Stephane Legriel |
| author_facet | Gilles Troché Virginie Laurent Alexis Ferré Gwenaelle Jacq Marine Paul Sybille Merceron Stephane Legriel |
| author_sort | Gilles Troché |
| collection | DOAJ |
| description | Abstract Natraemia is often abnormal in critically ill patients and may change rapidly during renal replacement therapy (RRT). This database study in a single intensive care unit (ICU) evaluated natraemia before and after the first RRT session for acute kidney injury. Of 252 patients who required RRT in 2018–2020, 215 were included. Prevalences were 53.9% for hyponatraemia (≤ 135 mmol/L) and 3.7% for hypernatraemia (> 145 mmol/L). Dialysate sodium was ≥ 145 mmol/L in 83% of patients. Median dialysis sodium gradient was 12 mmol/L, with a value above 16 mmol/L in 25% of patients. Median natraemia increased from 135 before to 140 mmol/L after RRT, the median hourly increase being faster than recommended, at 1.0 mmol/L [0.2–1.7]. By multivariate analysis, the only variable significantly associated with the RRT-induced natraemia change was the dialysis sodium gradient [odds ratio, 1.66; 95% confidence interval 1.39–2.10]. Pearson’s correlation coefficient between the gradient and the natraemia change was 0.57. When performing RRT in ICU patients, in addition to the haemodynamic considerations put forward in recommendations, the dialysis sodium gradient deserves careful attention in order to control natraemia variations. Studies to devise a formula for predicting natraemia variations might prove helpful to confirm our results. |
| first_indexed | 2024-04-12T23:28:43Z |
| format | Article |
| id | doaj.art-d0d7a435cb4644a6a2f52c69d725152b |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-04-12T23:28:43Z |
| publishDate | 2022-09-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-d0d7a435cb4644a6a2f52c69d725152b2022-12-22T03:12:21ZengNature PortfolioScientific Reports2045-23222022-09-011211810.1038/s41598-022-18897-zNatraemia variations induced by acute dialysis in critically ill patients: a database studyGilles Troché0Virginie Laurent1Alexis Ferré2Gwenaelle Jacq3Marine Paul4Sybille Merceron5Stephane Legriel6Service de Réanimation Médico-Chirurgicale, Hôpital André Mignot, Centre Hospitalier de VersaillesService de Réanimation Médico-Chirurgicale, Hôpital André Mignot, Centre Hospitalier de VersaillesService de Réanimation Médico-Chirurgicale, Hôpital André Mignot, Centre Hospitalier de VersaillesService de Réanimation Médico-Chirurgicale, Hôpital André Mignot, Centre Hospitalier de VersaillesService de Réanimation Médico-Chirurgicale, Hôpital André Mignot, Centre Hospitalier de VersaillesService de Réanimation Médico-Chirurgicale, Hôpital André Mignot, Centre Hospitalier de VersaillesService de Réanimation Médico-Chirurgicale, Hôpital André Mignot, Centre Hospitalier de VersaillesAbstract Natraemia is often abnormal in critically ill patients and may change rapidly during renal replacement therapy (RRT). This database study in a single intensive care unit (ICU) evaluated natraemia before and after the first RRT session for acute kidney injury. Of 252 patients who required RRT in 2018–2020, 215 were included. Prevalences were 53.9% for hyponatraemia (≤ 135 mmol/L) and 3.7% for hypernatraemia (> 145 mmol/L). Dialysate sodium was ≥ 145 mmol/L in 83% of patients. Median dialysis sodium gradient was 12 mmol/L, with a value above 16 mmol/L in 25% of patients. Median natraemia increased from 135 before to 140 mmol/L after RRT, the median hourly increase being faster than recommended, at 1.0 mmol/L [0.2–1.7]. By multivariate analysis, the only variable significantly associated with the RRT-induced natraemia change was the dialysis sodium gradient [odds ratio, 1.66; 95% confidence interval 1.39–2.10]. Pearson’s correlation coefficient between the gradient and the natraemia change was 0.57. When performing RRT in ICU patients, in addition to the haemodynamic considerations put forward in recommendations, the dialysis sodium gradient deserves careful attention in order to control natraemia variations. Studies to devise a formula for predicting natraemia variations might prove helpful to confirm our results.https://doi.org/10.1038/s41598-022-18897-z |
| spellingShingle | Gilles Troché Virginie Laurent Alexis Ferré Gwenaelle Jacq Marine Paul Sybille Merceron Stephane Legriel Natraemia variations induced by acute dialysis in critically ill patients: a database study Scientific Reports |
| title | Natraemia variations induced by acute dialysis in critically ill patients: a database study |
| title_full | Natraemia variations induced by acute dialysis in critically ill patients: a database study |
| title_fullStr | Natraemia variations induced by acute dialysis in critically ill patients: a database study |
| title_full_unstemmed | Natraemia variations induced by acute dialysis in critically ill patients: a database study |
| title_short | Natraemia variations induced by acute dialysis in critically ill patients: a database study |
| title_sort | natraemia variations induced by acute dialysis in critically ill patients a database study |
| url | https://doi.org/10.1038/s41598-022-18897-z |
| work_keys_str_mv | AT gillestroche natraemiavariationsinducedbyacutedialysisincriticallyillpatientsadatabasestudy AT virginielaurent natraemiavariationsinducedbyacutedialysisincriticallyillpatientsadatabasestudy AT alexisferre natraemiavariationsinducedbyacutedialysisincriticallyillpatientsadatabasestudy AT gwenaellejacq natraemiavariationsinducedbyacutedialysisincriticallyillpatientsadatabasestudy AT marinepaul natraemiavariationsinducedbyacutedialysisincriticallyillpatientsadatabasestudy AT sybillemerceron natraemiavariationsinducedbyacutedialysisincriticallyillpatientsadatabasestudy AT stephanelegriel natraemiavariationsinducedbyacutedialysisincriticallyillpatientsadatabasestudy |