title: Posttransplant Hyponatremia Predicts Graft Failure and Mortality in Kidney Transplantation Recipients: A Multicenter Cohort Study in Korea.
abstract: Although hyponatremia is related to poorer outcomes in several clinical settings, its significance remains unresolved in kidney transplantation. Data on 1,786 patients who received kidney transplantations between January 2000 and December 2011 were analyzed. The patients were divided into two groups according to the corrected sodium values for serum glucose 3 months after their transplantations (<135 mmol/L vs. ≥135 mmol/L). Subsequently, the hazard ratios (HRs) for biopsy-proven acute rejection, graft failure, and all-cause mortality were calculated after adjustments for several immunological and non-immunological covariates. 4.0% of patients had hyponatremia. Patients with hyponatremia had higher risks for graft failure and all-cause mortality than did the counterpart normonatremia group; the adjusted HRs for graft failure and mortality were 3.21 (1.47-6.99) and 3.03 (1.21-7.54), respectively. These relationships remained consistent irrespective of heart function. However, hyponatremia was not associated with the risk of acute rejection. The present study addressed the association between hyponatremia and graft and patient outcomes in kidney transplant recipients. Based on the study results, our recommendation is to monitor serum sodium levels after kidney transplantations.
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Seung Seok
authors.identifier: 0000-0003-0137-5261
authors.initials: SS
authors.lastname: Han
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Miyeun
authors.initials: M
authors.lastname: Han
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Jae Yoon
authors.initials: JY
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.|Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Korea.|Department of Critical Care Medicine, Seoul National University Boramae Medical Center, Seoul, Korea.
authors.forename: Jung Nam
authors.initials: JN
authors.lastname: An
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Seokwoo
authors.initials: S
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, Asan Medical Center and University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Su-Kil
authors.initials: SK
authors.lastname: Park
authors.affiliation: Department of Surgery, Asan Medical Center and University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Duck-Jong
authors.initials: DJ
authors.lastname: Han
authors.affiliation: Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Ki Young
authors.initials: KY
authors.lastname: Na
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.|Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Korea.
authors.forename: Yun Kyu
authors.initials: YK
authors.lastname: Oh
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.|Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Korea.
authors.forename: Chun Soo
authors.initials: CS
authors.lastname: Lim
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.|Kidney Research Institute, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Yon Su
authors.initials: YS
authors.lastname: Kim
authors.affiliation: Department of Surgery, Asan Medical Center and University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Young Hoon
authors.initials: YH
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.|Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Korea.|Kidney Research Institute, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Jung Pyo
authors.initials: JP
authors.lastname: Lee
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D006084:Graft Rejection / Q000175:diagnosis* / Q000209:etiology / Q000401:mortality; D006801:Humans; D007010:Hyponatremia / Q000175:diagnosis* / Q000209:etiology* / Q000401:mortality; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D056910:Republic of Korea / Q000453:epidemiology; D012720:Severity of Illness Index; D012964:Sodium / Q000097:blood; D016019:Survival Analysis; D066027:Transplant Recipients / Q000706:statistics & numerical data; D016896:Treatment Outcome
chemical_list: D012964:Sodium