Hypernatremia Linked to Post-Liver Transplant Mortality
(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, MD, from the Mayo Clinic in Rochester, MN, 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 2003–2010. Patients were categorized according to Na level: hyponatremic (Na≤130mEq/L), normonatremic (Na =131–145mEq/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% of patients and correlated with increased in-hospital death (11.2% vs. 4.2%; P<0.001) and reduced 90-day survival (86.4% vs. 94.0%; 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 >145mEq/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."