Hyponatremia in hospitalized patients with the acquired immunodeficiency syndrome (AIDS) and the AIDS-related complex.
OBJECTIVE
To determine the frequency, etiology, and clinical association of hyponatremia in patients with the acquired immunodeficiency syndrome (AIDS) and AIDS-related complex (ARC).


METHODS
A prospective analysis of 167 patients with AIDS and 45 patients with ARC admitted on 259 occasions to a large metropolitan teaching hospital during a 3-month period.


RESULTS
Eighty-three patients (39%) with hyponatremia (serum sodium concentration less than 135 mmol/L) were observed during 99 hospitalizations, for a frequency of 38%. The mean (+/- standard error) of the lowest serum sodium concentration was 128 +/- 1 mmol/L in the hyponatremic patients and 138 +/- 1 mmol/L in the normonatremic patients. Hyponatremia was present on admission during 57 hospitalizations and was associated with gastrointestinal losses and hypovolemia in 43%. When hyponatremia developed during hospitalization, 68% of the patients were clinically euvolemic and had a syndrome consistent with inappropriate secretion of antidiuretic hormone (SIADH). Patients with hyponatremia were hospitalized longer than those with normal serum sodium concentrations (17 +/- 1 versus 9 +/- 1 days, p < 0.001). In addition, the mortality rate in the hyponatremic group was higher than that in the normonatremic group (36.5% versus 19.7%, p < 0.01).


CONCLUSIONS
Hyponatremia is a common electrolyte disorder in patients hospitalized with AIDS or ARC and is frequently associated with gastrointestinal losses or SIADH as well as increased morbidity and mortality.
Tang
W W
WW
Division of Nephrology, University of Southern California, Los Angeles.
Kaptein
E M
EM
Feinstein
E I
EI
Massry
S G
SG
D000386:AIDS-Related Complex / Q000150:complications*; D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D000328:Adult; D001424:Bacterial Infections / Q000150:complications; D001810:Blood Volume; D003967:Diarrhea / Q000150:complications; D005260:Female; D006760:Hospitalization; D006801:Humans; D007010:Hyponatremia / Q000097:blood / Q000150:complications* / Q000503:physiopathology; D007177:Inappropriate ADH Syndrome / Q000150:complications; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D015270:Mycobacterium avium-intracellulare Infection / Q000150:complications; D009422:Nervous System Diseases / Q000150:complications; D011020:Pneumonia, Pneumocystis / Q000150:complications; D011446:Prospective Studies; D051437:Renal Insufficiency / Q000150:complications; D012964:Sodium / Q000097:blood; D014839:Vomiting / Q000150:complications
D012964:Sodium