title: Hyponatremia in acute-phase response syndrome patients in general surgical wards.
abstract: BACKGROUND
  In surgical patients, hypoalbuminemia may occur as a component of acute-phase response (APR) syndrome, which we hypothesized could decrease serum sodium levels.
  
  
  OBJECTIVE
  To compare the frequency of hyponatremia in adult surgical inpatients with or without APR syndrome.
  
  
  METHODS
  All the simultaneous plasma sodium and albumin results (n = 168), obtained from adults in surgical wards and corresponding to a 6-month period, were searched in the hospital mainframe. Other relevant laboratory and clinical data were also registered. APR was ascertained by the presence of major physical trauma, surgery or infection, plus hypoalbuminemia (serum albumin <3.5 g/dl) and neutrophil left shift (>/=7% of band count) associated with peripheral leukopenia (white blood cells <4, 000/mm(3)) or leukocytosis (WBC >9,000/mm(3)). Hyponatremia was defined by serum sodium concentration <135 mEq/l.
  
  
  RESULTS
  APR-positive patients (n = 113) had lower blood hemoglobin (10.92 +/- 2.18 vs. 13.53 +/- 2.30 g/dl), and serum albumin levels (median, range: 2.8, 1.9-3.4 vs. 3.7, 3.5-4.2 g/dl) than APR-negative (n = 55) ones, the same occurring in relation to antibiotics (54.8 vs. 10. 9%) and intravenous 5% dextrose in water (55.7 vs. 20.0%) or isotonic saline (46.0 vs. 9.1%) infusion. The hyponatremia frequency was higher among APR-positive patients (31.0 vs. 10.9%).
  
  
  CONCLUSIONS
  The higher percentage of hyponatremia among APR-positive patients could be attributed to decreased serum albumin levels associated with APR.
authors.affiliation: Nutrition Division, Department of Internal Medicine, Medical School of Uberaba, Brazil. dfcnutro@mednet.com.br
authors.forename: D
authors.initials: D
authors.lastname: Ferreira da Cunha
authors.forename: J
authors.initials: J
authors.lastname: Pontes Monteiro
authors.forename: V
authors.initials: V
authors.lastname: Modesto dos Santos
authors.forename: F
authors.initials: F
authors.lastname: Araújo Oliveira
authors.forename: S
authors.initials: S
authors.lastname: Freire de Carvalho da Cunha
mesh_terms: D000210:Acute-Phase Reaction / Q000097:blood / Q000150:complications*; D016022:Case-Control Studies; D005260:Female; D006757:Hospital Units; D006801:Humans; D007010:Hyponatremia / Q000097:blood / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012709:Serum Albumin / Q000378:metabolism; D013514:Surgical Procedures, Operative
chemical_list: D012709:Serum Albumin