Prevalence and incidence of hyponatremia and their association with diuretic therapy: Results from North India

Abhishek Singh; Ramesh Ahuja; Rishi Sethi; Akshyaya Pradhan; Vinod Srivastava

doi:10.4103/jfmpc.jfmpc_604_19

Prevalence and incidence of hyponatremia and their association with diuretic therapy: Results from North India

J Family Med Prim Care. 2019 Dec 10;8(12):3925-3930. doi: 10.4103/jfmpc.jfmpc_604_19. eCollection 2019 Dec.

Authors

Abhishek Singh¹, Ramesh Ahuja², Rishi Sethi³, Akshyaya Pradhan⁴, Vinod Srivastava^{1

2

3

4}

Affiliations

¹ Deparment of Internal Medicine, King George's Medical University, Lucknow, Uttar Pradesh, India.
² Department of Internal Medicine, ApolloMedics Hospital and Research Center, Lucknow, Uttar Pradesh, India.
³ Deparment of Cardiology, King George's Medical University, Lucknow, Uttar Pradesh, India.
⁴ Principal, Prasad Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.

Abstract

Introduction: Hyponatremia is associated with substantial morbidity and mortality. Correct estimation of their prevalence, incidence and risk factors, especially the diuretics in Indian patients is important in determining preventive strategies.

Methods: This multistage mixed methods-based study was conducted in a high-volume cardiac care center to ensure the correct estimation. Patients receiving oral diuretics on an outpatient basis and those admitted to hospital for hyponatremia were enrolled.

Results: The prevalence of hyponatremia was 27% while the incidence rate was 18% and 29% after 3- and 6-month of the diuretic therapy. The highest rates of hyponatremia were observed in warm season (45%, 111 in 247 patients). Multivariate logistic regression analysis revealed that low solute and nutritious intake and edematous state were negatively correlated with serum sodium levels. Neither diarrhea/vomiting nor diuretic use were found to be associated with hyponatremia.

Conclusions: Diuretics use was not associated with hyponatremia in adults in this population cohort. However, elderly people on diuretics are comparatively more likely to have hyponatremia. However, a randomized parallel arm trial comparing diuretics with other antihypertensives be done to establish whether diuretics are associated with hyponatremia in this patient population.

Keywords: Loop diuretics; seasonal variation; serum sodium.