title: Hyponatremia, acute kidney injury, and mortality in HIV-related toxoplasmic encephalitis.
abstract: BACKGROUND
  There are no reports on hyponatremia and acute kidney injury (AKI) involved in the course of HIV-related toxoplasmic encephalitis (TE). The main objective of this study was to describe the occurrence of hyponatremia and its relationship with AKI and mortality in HIV-related toxoplasmic encephalitis (TE).
  
  
  METHODS
  This was a retrospective cohort study on patients with HIV-related TE. AKI was considered only when the RIFLE (risk, injury, failure, loss, end-stage) criterion was met, after the patient was admitted.
  
  
  RESULTS
  A total of 92 patients were included, with a mean age of 36±9 years. Hyponatremia at admission was observed in 43 patients (46.7%), with AKI developing in 25 (27.1%) patients during their hospitalization. Sulfadiazine was the treatment of choice in 81% of the cases. Death occurred in 13 cases (14.1%). Low serum sodium level correlated directly with AKI and mortality. Male gender (OR 7.89, 95% CI 1.22-50.90, p = 0.03) and hyponatremia at admission (OR 4.73, 95% CI 1.22-18.30, p = 0.02) were predictors for AKI. Independent risk factors for death were AKI (OR 8.3, 95% CI 1.4-48.2, p < 0.0001) and hyponatremia (OR 9.9, 95% CI 1.2-96.3, p < 0.0001).
  
  
  CONCLUSIONS
  AKI and hyponatremia are frequent in TE. Hyponatremia on admission is highly associated with AKI and mortality.
authors.affiliation: School of Medicine, Health Sciences Center, Universidade de Fortaleza, Fortaleza, CE, Brazil.
authors.forename: Alexandre B
authors.initials: AB
authors.lastname: Libório
authors.forename: Geraldo B
authors.initials: GB
authors.lastname: Silva
authors.forename: Carolina G C H
authors.initials: CG
authors.lastname: Silva
authors.forename: Francisco J C
authors.initials: FJ
authors.lastname: Lima Filho
authors.forename: Adalberto
authors.initials: A
authors.lastname: Studart Neto
authors.forename: Willy
authors.initials: W
authors.lastname: Okoba
authors.forename: Veralice M S
authors.initials: VM
authors.lastname: de Bruin
authors.forename: Sônia M H A
authors.initials: SM
authors.lastname: Araújo
authors.forename: Elizabeth F
authors.initials: EF
authors.lastname: Daher
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000150:complications* / Q000401:mortality; D058186:Acute Kidney Injury / Q000209:etiology* / Q000401:mortality; D000328:Adult; D015331:Cohort Studies; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007010:Hyponatremia / Q000209:etiology* / Q000401:mortality; D008297:Male; D012189:Retrospective Studies; D016781:Toxoplasmosis, Cerebral / Q000150:complications* / Q000401:mortality