Table 2.
Relationships between serum sodium levels stratified by eGFR levels and outcomes
| Natremia Statusa at Hospital Admission | In-Hospital Mortality | Discharge to a Hospice | Discharge to a Nursing Facility |
|---|---|---|---|
| Adjustedb Odds Ratio (95% Confidence Interval) | Adjustedb Odds Ratio (95% Confidence Interval) | Adjustedb Odds Ratio (95% Confidence Interval) | |
| Normonatremia | 1 | 1 | 1 |
| Hypernatremia | |||
| Mild | 4.8 (4.6 to 4.9) | 2.1 (1.9 to 2.3) | 2.1 (2 to 2.1) |
| Moderate | 22.6 (20.9 to 24.4) | 10.41 (9 to 12) | 6.97 (6.5 to 7.5) |
| Severe | 34.4 (30.6 to 38.7) | 21.1 (17.5 to 25.5) | 12.2 (11 to 13.6) |
| eGFR level, ml/min per 1.73 m2 | |||
| Normonatremia | |||
| <15 | 5.4 (5.1 to 5.6) | 0.8 (0.7 to 0.9) | 1.4 (1.3 to 1.4) |
| 15–29 | 5.5 (5.3 to 5.8) | 1 (0.9 to 1.1) | 1.4 (1.3 to 1.4) |
| 30–59 | 2.3 (2.2 to 2.4) | 0.5 (0.5 to 0.5) | 1 (1 to 1) |
| 60–89 | 1.5 (1.4 to 1.5) | 0.6 (0.5 to 0.6) | 0.9 (0.9 to 1) |
| ≥90 | 1 | 1 | 1 |
| Mild hypernatremia | |||
| <15 | 14 (12.4 to 16) | 0.1 (0.1 to 0.3) | 2.7 (1.9 to 2.4) |
| 15–29 | 19.2 (17.6 to 21.1) | 0.4 (0.3 to 0.5) | 4 (3.7 to 4.3) |
| 30–59 | 11.9 (11.2 to 12.7) | 2 (1.7 to 2.1) | 2.5 (2.4 to 2.6) |
| 60–89 | 6 (5.5 to 6.4) | 1.7 (1.5 to 1.9) | 1.6 (1.6 to 1.7) |
| ≥90 | 8.1 (7.4 to 8.7) | 1.6 (1.3 to 2) | 2.2 (2 to 2.3) |
| Moderate hypernatremia | |||
| <15 | 54.6 (42.5 to 70.2) | 0.17 (0 to 1.9) | 6.6 (5.2 to 8.4) |
| 15–29 | 69.3 (55.8 to 86) | 3.91 (2.3 to 6.6) | 16.5 (13.6 to 20.1) |
| 30–59 | 22 (19 to 25.4) | 5 (3.9 to 6.4) | 5.4 (4.8 to 6.1) |
| 60–89 | 36.6 (30.6 to 43.9) | 36.4 (29.5 to 44.8) | 11.6 (10 to 13.5) |
| ≥90 | 15.5 (12.5 to 19.3) | 0 (NA) | 4 (3.3 to 4.8) |
| Severe hypernatremia | |||
| <15 | 656.5 (328.7 to 1311.1) | 4.2 (0.5 to 34.2) | 124.3 (62.8 to 246.6) |
| 15–29 | 849 (67.2 to 107.2) | 9.1 (6.1 to 13.7) | 10.7 (8.5 to 13.4) |
| 30–59 | 89.6 (73.4 to 109.3) | 12.2 (8.5 to 17.4) | 15.2 (12.6 to 18.4) |
| 60–89 | 300.5 (215.1 to 419.9) | 52.2 (32.2 to 84.7) | 33.6 (23.9 to 47.3) |
| ≥90 | 30 (19.9 to 45.4) | 34.6 (19.6 to 61) | 10 (7 to 14.2) |
Normonatremia: Na >135–145 mEq/L; hypernatremia: Na >145 mEq/L (mild hypernatremia: Na >145–150 mEq/L; moderate hypernatremia: Na >150–155 mEq/L; severe hypernatremia: Na >155 mEq/L). Na, serum sodium level; OR, odds ratio.
a
Na levels corrected by adding 1.6 mEq/L for each 100 mg/dl above 100 mg/dl of the concomitantly measured serum glucose levels.
b
The adjusted ORs were derived from a multinomial logistic regression model adjusted for age, sex, race, CKD, and the Quan-CCI (all P<0.001).