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The Impact of Albumin Use on Resolution of Hyponatremia in Hospitalized Patients With Cirrhosis.
Bajaj, Jasmohan S; Tandon, Puneeta; OʼLeary, Jacqueline G; Biggins, Scott W; Wong, Florence; Kamath, Patrick S; Garcia-Tsao, Guadalupe; Maliakkal, Benedict; Lai, Jennifer C; Fallon, Michael; Thuluvath, Paul; Vargas, Hugo E; Subramanian, Ram M; Thacker, Leroy R; Reddy, Rajender K.
Afiliación
  • Bajaj JS; Virginia Commonwealth university and McGuire VA Medical Center, Richmond, VA, uSA. university of Alberta, Edmonton, AB, Canada. Dallas VA Medical Center and Baylor University Medical Center, Dallas, TX, USA. University of Washington, Seattle, WA, USA. University of Denver, Colorado, CO, USA. Univers
  • Tandon P; Virginia Commonwealth university and McGuire VA Medical Center, Richmond, VA, uSA. university of Alberta, Edmonton, AB, Canada. Dallas VA Medical Center and Baylor University Medical Center, Dallas, TX, USA. University of Washington, Seattle, WA, USA. University of Denver, Colorado, CO, USA. Univers
  • OʼLeary JG; Virginia Commonwealth university and McGuire VA Medical Center, Richmond, VA, uSA. university of Alberta, Edmonton, AB, Canada. Dallas VA Medical Center and Baylor University Medical Center, Dallas, TX, USA. University of Washington, Seattle, WA, USA. University of Denver, Colorado, CO, USA. Univers
  • Biggins SW; Virginia Commonwealth university and McGuire VA Medical Center, Richmond, VA, uSA. university of Alberta, Edmonton, AB, Canada. Dallas VA Medical Center and Baylor University Medical Center, Dallas, TX, USA. University of Washington, Seattle, WA, USA. University of Denver, Colorado, CO, USA. Univers
  • Wong F; Virginia Commonwealth university and McGuire VA Medical Center, Richmond, VA, uSA. university of Alberta, Edmonton, AB, Canada. Dallas VA Medical Center and Baylor University Medical Center, Dallas, TX, USA. University of Washington, Seattle, WA, USA. University of Denver, Colorado, CO, USA. Univers
  • Kamath PS; Virginia Commonwealth university and McGuire VA Medical Center, Richmond, VA, uSA. university of Alberta, Edmonton, AB, Canada. Dallas VA Medical Center and Baylor University Medical Center, Dallas, TX, USA. University of Washington, Seattle, WA, USA. University of Denver, Colorado, CO, USA. Univers
  • Garcia-Tsao G; Virginia Commonwealth university and McGuire VA Medical Center, Richmond, VA, uSA. university of Alberta, Edmonton, AB, Canada. Dallas VA Medical Center and Baylor University Medical Center, Dallas, TX, USA. University of Washington, Seattle, WA, USA. University of Denver, Colorado, CO, USA. Univers
  • Maliakkal B; Virginia Commonwealth university and McGuire VA Medical Center, Richmond, VA, uSA. university of Alberta, Edmonton, AB, Canada. Dallas VA Medical Center and Baylor University Medical Center, Dallas, TX, USA. University of Washington, Seattle, WA, USA. University of Denver, Colorado, CO, USA. Univers
  • Lai JC; Virginia Commonwealth university and McGuire VA Medical Center, Richmond, VA, uSA. university of Alberta, Edmonton, AB, Canada. Dallas VA Medical Center and Baylor University Medical Center, Dallas, TX, USA. University of Washington, Seattle, WA, USA. University of Denver, Colorado, CO, USA. Univers
  • Fallon M; Virginia Commonwealth university and McGuire VA Medical Center, Richmond, VA, uSA. university of Alberta, Edmonton, AB, Canada. Dallas VA Medical Center and Baylor University Medical Center, Dallas, TX, USA. University of Washington, Seattle, WA, USA. University of Denver, Colorado, CO, USA. Univers
  • Thuluvath P; Virginia Commonwealth university and McGuire VA Medical Center, Richmond, VA, uSA. university of Alberta, Edmonton, AB, Canada. Dallas VA Medical Center and Baylor University Medical Center, Dallas, TX, USA. University of Washington, Seattle, WA, USA. University of Denver, Colorado, CO, USA. Univers
  • Vargas HE; Virginia Commonwealth university and McGuire VA Medical Center, Richmond, VA, uSA. university of Alberta, Edmonton, AB, Canada. Dallas VA Medical Center and Baylor University Medical Center, Dallas, TX, USA. University of Washington, Seattle, WA, USA. University of Denver, Colorado, CO, USA. Univers
  • Subramanian RM; Virginia Commonwealth university and McGuire VA Medical Center, Richmond, VA, uSA. university of Alberta, Edmonton, AB, Canada. Dallas VA Medical Center and Baylor University Medical Center, Dallas, TX, USA. University of Washington, Seattle, WA, USA. University of Denver, Colorado, CO, USA. Univers
  • Thacker LR; Virginia Commonwealth university and McGuire VA Medical Center, Richmond, VA, uSA. university of Alberta, Edmonton, AB, Canada. Dallas VA Medical Center and Baylor University Medical Center, Dallas, TX, USA. University of Washington, Seattle, WA, USA. University of Denver, Colorado, CO, USA. Univers
  • Reddy RK; Virginia Commonwealth university and McGuire VA Medical Center, Richmond, VA, uSA. university of Alberta, Edmonton, AB, Canada. Dallas VA Medical Center and Baylor University Medical Center, Dallas, TX, USA. University of Washington, Seattle, WA, USA. University of Denver, Colorado, CO, USA. Univers
Am J Gastroenterol ; 113(9): 1339, 2018 09.
Article en En | MEDLINE | ID: mdl-29880972
ABSTRACT

OBJECTIVES:

Hyponatremia is associated with poor outcomes in cirrhosis independent of MELD. While intravenous albumin has been used in small series, its role in hyponatremia is unclear. The aim of this study is to determine the effect of albumin therapy on hyponatremia.

METHODS:

Hospitalized cirrhotic patients included in the NACSELD (North American Consortium for End-Stage Liver Disease) cohort with hyponatremia (Na <130mmol/L) were divided into those receiving intravenous albumin or not. Determinants of hyponatremia resolution (Na ≥135 meq/L) and 30-day survival were analyzed using regression and ANCOVA models.

RESULTS:

Overall, 2435 patients, of whom 1126 had admission hyponatremia, were included. Of these, 777 received 225 (IQR 100,400) g of albumin, while 349 did not. Patients given albumin had a higher admission MELD score, and serum creatinine and lower admission Na and mean arterial pressure (MAP). However they experienced a higher maximum Na and hyponatremia resolution (69% vs 61%, p = 0.008) compared to those who did not. On regression, delta Na was independently associated with admission creatinine, MAP and albumin use. On ANCOVA with logistic regression, there was a significant difference in hyponatremia resolution between those who did or did not receive albumin, even after adjustment for admission Na and GFR (85.41% vs 44.78%, p = 0.0057, OR 1.50 95% CI 1.13-2.00). Independent predictors of 30-day survival were hyponatremia resolution, age, ACLF, and admission GFR.

CONCLUSION:

Hospitalized patients with cirrhosis and hyponatremia who received intravenous albumin had a higher rate of hyponatremia resolution independent of renal function and baseline sodium levels, which was in turn associated with a better 30-day survival.
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Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Enfermedad Hepática en Estado Terminal / Albúmina Sérica Humana / Hiponatremia / Cirrosis Hepática Tipo de estudio: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Am J Gastroenterol Año: 2018 Tipo del documento: Article
Texto completo
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XML
PubMed Links
Buscar en Google

Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Enfermedad Hepática en Estado Terminal / Albúmina Sérica Humana / Hiponatremia / Cirrosis Hepática Tipo de estudio: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Am J Gastroenterol Año: 2018 Tipo del documento: Article