title: Moderate/Severe hyponatremia increases the risk of death among hospitalized Chinese human immunodeficiency virus/acquired immunodeficiency syndrome patients.
abstract: OBJECTIVE
  To evaluate whether the serum sodium concentration is associated with the progression and long-term prognosis of Chinese HIV/AIDS patients.
  
  
  METHODS
  Three hundred and eighty seven hospitalized patients were recruited into this retrospective cohort study. The strata of serum sodium concentration were moderate/severe hyponatremia, mild hyponatremia and normonatremia. Disease progression was estimated using CD4 counts and the WHO clinical stage. Correlation analysis was used to evaluate the serum sodium concentration with disease progression. The Kaplan-Meier method and the Cox proportional hazards model were used to analyze the effect of different serum sodium levels on survival.
  
  
  RESULTS
  In this study 206 patients (53.2%) had hyponatremia, including 10.6% patients with moderate/severe hyponatremia and 42.6% with mild hyponatremia. The serum sodium concentration was significantly correlated with the HIV/AIDS progression (P<0.001). During the follow-up, 100 patients (25.6%) died. The cumulative survival rates of HIV/AIDS patients were 47.8% ± 8.5% in patients with moderate/severe hyponatremia, 59.8% ± 5.0% with mild hyponatremia and 79.9% ± 3.4% with normonatremia (log-rank P<0.001). After adjusting for sex, age, WHO stage, CD4 count, hemoglobin and albumin, the relative hazard was 3.5 (95% CI: 1.9-6.5) for patients with moderate/severe hyponatremia (P<0.001), and 1.5 (95% CI: 0.9-2.4) for those with mild hyponatremia (P = 0.161), compared with normonatremic patients.
  
  
  CONCLUSIONS
  The serum sodium level is closely correlated with the severity of patients. Only moderate/severe hyponatremia affects the prognosis of Chinese HIV/AIDS patients. Earlier intensive medical managements(including HAART)are necessary to increase the survival rates of Chinese HIV/AIDS patients with moderate/severe hyponatremia.
authors.affiliation: The State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou City, China; Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou City, China.
authors.forename: Lijun
authors.initials: L
authors.lastname: Xu
authors.affiliation: Clinical Center of HIV/AIDS, Fuzhou Infectious Disease Hospital, Fujian Medical University, Fuzhou City, China.
authors.forename: Hanhui
authors.initials: H
authors.lastname: Ye
authors.affiliation: Department of Infectious Diseases, Jianxin Hospital of Fujian Province, Fuzhou City, China.
authors.forename: Fan
authors.initials: F
authors.lastname: Huang
authors.affiliation: The State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou City, China.
authors.forename: Zongxing
authors.initials: Z
authors.lastname: Yang
authors.affiliation: The State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou City, China; Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou City, China.
authors.forename: Biao
authors.initials: B
authors.lastname: Zhu
authors.affiliation: The State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou City, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Xu
authors.affiliation: The State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou City, China; Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou City, China.
authors.forename: Yunqing
authors.initials: Y
authors.lastname: Qiu
authors.affiliation: The State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou City, China; Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou City, China.
authors.forename: Lanjuan
authors.initials: L
authors.lastname: Li
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000097:blood* / Q000401:mortality; D000328:Adult; D002681:China / Q000453:epidemiology; D018450:Disease Progression; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007010:Hyponatremia / Q000097:blood* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D012964:Sodium / Q000097:blood; D015996:Survival Rate
chemical_list: D012964:Sodium