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KMID : 0359920110300050468
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Korean Journal of Nephrology
2011 Volume.30 No. 5 p.468 ~ p.474
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Clinical Features of Hyponatremia: Changes Related to Increasing Use of Thiazide-Combination Diuretics
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Cha In-Hye
Cho Eun-Jung
Yoon Gi-Chol
Noh Hye-jin
Choi Hye-Min
Lee Jae-Won
Jo Sang-Kyung
Kim Hyung-Kyu
Cho Won-Yong
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Abstract
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Purpose:In this study, the etiology and the change of clinical characteristics of hyponatremia, in relation to the increased used of thiazide diuretics, have been assessed.
Methods:To perform a retrospective cohort study, a total sum of 322 patients who have been admitted in a single tertiary referral hospital between 2004 and 2009, were included.
Results:The most common cause of hyponatremia was due to thiazide diuretics (37.6%). Among the 121 patients who suffered from thiazide induced hyponatremia, 60 (48.0%) patients took combination thiazide. The incidence of hyponatremia has shown a tendency to increase from 2004 to 2009 (trend test, p<0.001). The incidence of hyponatremia due to the use of combination types has also increased (trend test, p<0.001). Thiazide induced hyponatremia showed no difference when compared to hyponatremia due the other causes, except the fact that the portion of female patients was higher (73.6% vs 64.6%, p<0.001), mean age was older (74.7 vs 69.9 years-old, p<0.001), and incidence of cerebrovascular accident was also higher (19.8% vs 6.5%, p<0.001).
Conclusion:The use of thiazide is increasing and hence thiazide-induced hyponatremia is also increasing. This is thought to be particularly related to the increase of thiazide-combined drugs. Thiazideinduced hyponatremia shows a higher incidence in old age, female sex and those who have a history of a cerebrovascular event. Hence more caution is needed when using thiazide diuretics as antihypertensives, and plasma sodium levels should be monitored carefully.
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KEYWORD
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Hyponatremia, Incidence, Diuretics
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