Hypernatremia Linked to Post-Liver Transplant Mortality
However, pre-transplant hyponatremia does not affect in-hospital mortality or 90-day survival
TUESDAY, April 8, 2014 (HealthDay News) -- Pre-liver transplant (LTx) hyponatremia does not affect post-LTx survival, but hypernatremia is a significant risk factor for post-LTx mortality, according to a study published online Feb. 25 in Liver Transplantation.
Michael D. Leise, M.D., from the Mayo Clinic in Rochester, Minn., and colleagues investigated the impact of pre-LTx serum sodium (Na) on post-LTx outcomes. Data were collected from 19,537 patients with available information about serum Na immediately before LTx from 2003 to 2010. Patients were categorized according to Na level: hyponatremic (Na ≤130 mEq/L), normonatremic (Na =131 to 145 mEq/L), and hypernatremic (Na >145 mEq/L), and their post-LTx outcomes were compared.
The researchers found that neither in-hospital mortality nor 90-day survival differed between patients with hyponatremia and normonatremia. Hypernatremia was present in 2.4 percent of patients and correlated with increased in-hospital death (11.2 versus 4.2 percent; P < 0.001) and reduced 90-day survival (86.4 versus 94.0 percent; P < 0.001). The association between preLTx hypernatremia and posttransplant mortality remained significant after adjustment for clinical variables, with a hazard ratio of 1.13 for each unit increase in sodium >145 mEq/L (P < 0.001). In hypernatremic patients, the length of hospitalization after LTx was significantly longer (P < 0.001).
"In conclusion, hyponatremia per se does not affect post-LTx survival," the authors write. "Pre-LTx hypernatremia is a highly significant risk factor for post-LTx mortality."