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

Abstract

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. 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. 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. 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.