Doroh, Nuraina Syazreena Ab
(2020)
The study of clinical and biochemical factors associated with hypovolemia among hospitalised patients with hyponatremia based on bioimpedence analysis in Hospital USM Kubang Kerian.
Masters thesis, Universiti Sains Malaysia.
Abstract
Background: Hydration status assessment is important in management of patient with hyponatremia. There is no previous study that shows association between patients’s clinical and biochemical assessment with hydration status in hospitalized patients with hyponatremia. Objective of this study was to look at the association between clinical and biochemical parameters in patient and hypovolemic hyponatremia.
Methods: This cross-sectional study was conducted in June 2020 till August 2020 involving patients with hyponatremia, hospitalized in Hospital Universiti Sains Malaysia. A total of 87 patients with hyponatremia were selected. All patients’ information such as age, comorbidities, drug history particularly diuretics, diagnosis during admission, weight, height, body mass index, clinical assessment including systolic and diastolic blood pressure , heart rate and sternal skin turgor as well as biochemical parameters such as serum sodium, serum urea, serum uric acid, serum and urine osmolarity, urine sodium were obtained, followed by assessment of hydration status using Biolectrical Impedance Analysis Machine (Bodystat Quadscan). Results of hydration status will be divided into hypovolemic and non-hypovolemic group based on total body water analysis. Univariable and multivariable analysis by logistic regression were conducted to identify association of this clinical and biochemical parameters with hypovolemic hyponatremia.
Results: Among 87 patients with hyponatremia, 35 (40.2%) of them had hypovolemia and 52 (59.8%) had non-hypovolemia. Hypovolemic group consists of 23 (65.7%) female and 12 (34.3%) male. The mean (SD) serum Na for hypovolemic group and non-hypovolemic group were 126.9 (±4.27) and 127 (±4.52) respectively. In hypovolemic group, 5 (14.3%) had underlying malignancy and 14 (40%) had
underlying DM. Mean BMI for hypovolemic group was 23.6 (±4.24) and 22.7 (±2.84) for non-hypovolemic hyponatremia group. Significant association of low systolic BP and high serum urea with hypovolemic hyponatremia have been found (adj OR 0.92, 95% CI 0.873, 0.969, p=0.002; adj OR 1.27, 95% CI 1.12, 1.43, p <0.001)
Conclusion: Low systolic BP and high serum urea are significantly associated with hypovolemic hyponatremia among hospitalized patients with hyponatremia. Hence, assessment of systolic BP and measurement of serum urea can helps in predicting hospitalized patient with hypovolemic hyponatremia and to guide for further workout to look for the possible etiology and endorsing subsequent management
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