title: Clinical and Genetic Factors Associated With Thiazide-Induced Hyponatremia.
abstract: Thiazide diuretics are associated with an increased risk of hyponatremia. The aim of this study was to investigate possible predictors of thiazide-induced hyponatremia.A total of 48 patients admitted to the ward or to the emergency department due to severe thiazide-induced hyponatremia (Na < 125 mmol/L) were enrolled in our study as the case group. Another 211 hypertensive patients with normal sodium levels after treatment with thiazide diuretics were selected as the control group. Twelve tag single nucleotide polymorphism markers were selected from the Potassium Channel, Inwardly Rectifying Subfamily J, Member 1 (KCNJ1) gene: rs1231254, rs2238009, rs1148058, rs675482, rs673614, rs12795437, rs2855800, rs2509585, rs3016774, rs881333, rs4529890, and rs7116606. Clinical and genetic parameters between patients with thiazide-induced hyponatremia and the control group were compared. Logistic regression was used to analyze data.The patients with thiazide-induced hyponatremia were older (P < 0.001), predominantly female (P = 0.008), had a lower mean body mass index (BMI) (P < 0.001), and more commonly used angiotensin II receptor antagonist (P < 0.001) and spironolactone (P = 0.007) compared with the control groups. Analysis with multivariate logistic regression revealed that age (odds ratio [OR], 1.13; 95% confidence interval [CI], 1.08-1.19, P < 0.001), female gender (OR, 4.49; 95% CI, 1.54-13.11, P = 0.006), BMI (OR, 0.80; 95% CI, 0.69-0.93, P = 0.003), and KCNJ1 rs2509585 C/T or T/T polymorphisms (OR, 5.75; 95% CI, 1.25-26.45, P = 0.03) were independent predictors for thiazide-induced hyponatremia.Older female patients with lower BMIs and KCNJ1 rs2509585 C/T or T/T polymorphisms were more likely to develop thiazide-induced hyponatremia.
authors: From the Department of Medical Education (C-CH); Department of Medical Research (S-JL, J-WC); Division of Cardiology, Department of Medicine (C-CH, H-BL, P-HH, C-CC, T-CW, S-JL, J-WC); Healthcare and Management Center (H-BL); Division of Endocrinology and Metabolism, Department of Medicine (L-YL); Division of Nephrology, Department of Medicine (C-CL, C-YY, S-yL); Department of Emergency Medicine, Taipei Veterans General Hospital (Y-CC); Cardiovascular Research Center (C-CH, H-BL, P-HH, C-CC, T-CW, S-JL, J-WC); Institute of Pharmacology (C-CH, S-IH, L-YL, J-WC); Institute of Clinical Medicine, National Yang-Ming University (H-BL, P-HH, T-CW, S-JL); Institute of Biomedical Sciences, Academia Sinica (W-HP); Institute of Epidemiology, School of Public Health, National Taiwan University, Taipei (W-HP); Environment-Omics-Disease Research Centre, China Medical University Hospital (C-MC); Graduate Institute of Clinical Medical Science, China Medical University, Taichung (C-MC); and Institute of Population Health Science, National Health Research Institutes, Miaoli, Taiwan, R.O.C. (W-HP).
authors: Chin-Chou
authors: CC
authors: Huang
authors: Chia-Min
authors: CM
authors: Chung
authors: Shuen-Iu
authors: SI
authors: Hung
authors: Wen-Harn
authors: WH
authors: Pan
authors: Hsin-Bang
authors: HB
authors: Leu
authors: Po-Hsun
authors: PH
authors: Huang
authors: Chun-Chih
authors: CC
authors: Chiu
authors: Liang-Yu
authors: LY
authors: Lin
authors: Chih-Ching
authors: CC
authors: Lin
authors: Chih-Yu
authors: CY
authors: Yang
authors: Szu-Yuan
authors: SY
authors: Li
authors: Yen-Chia
authors: YC
authors: Chen
authors: Tao-Cheng
authors: TC
authors: Wu
authors: Shing-Jong
authors: SJ
authors: Lin
authors: Jaw-Wen
authors: JW
authors: Chen
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007010:Hyponatremia / Q000139:chemically induced* / Q000235:genetics; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D049993:Sodium Chloride Symporter Inhibitors / Q000009:adverse effects*
chemical_list: D049993:Sodium Chloride Symporter Inhibitors