Clinical research studyPrevalence of Hyponatremia and Association with Mortality: Results from NHANES
Section snippets
Materials and Methods
The National Health and Nutrition Examination Survey (NHANES) is conducted by the National Center for Health Statistics. Since 1999, data have been collected continuously from a representative sample of the civilian non-institutionalized population of the United States via in-home personal interviews and physical examinations in mobile examination centers, including laboratory measurements of serum electrolytes, creatinine, protein, and lipids.25 NHANES uses a complex, multistage probability
Results
Overall, 31,116 subjects were surveyed during the continuous NHANES cycles between 1999 and 2004. Our analysis included 14,804 subjects aged 18 years or more who had a measured serum sodium concentration. Hyponatremia was defined as serum sodium below the reference ranges provided by the NHANES laboratory testing centers, which were 133 to 145 mmol/L for the 1999-2002 survey cycles and 136 to 144 mmol/L for 2003-2004.27, 28, 29 Subjects with hypernatremia were excluded (n = 88), as were 19
Discussion
We report, for the first time, an estimate of the prevalence of hyponatremia in the general US population and its relative prevalence in subjects with and without specific comorbidities. Our analysis demonstrates an increase in the prevalence of hyponatremia with age and a higher prevalence of hyponatremia among women in the general population, a finding that was suspected given similar trends previously reported among cohorts of patients in acute and long-term care facilities, and a previously
Conclusions
After excluding cases of pseudohyponatremia and correcting for dilutional hyponatremia, our analysis of the NHANES 1999-2004 cohort estimates the overall prevalence of hyponatremia to be 1.72% of the US population. We demonstrate an increasing prevalence of hyponatremia with increasing age in the population, higher rates of hyponatremia among women, and a significant association between hyponatremia and all-cause mortality that persists even after adjustments for age, gender, and several
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Funding: This work was supported in part by Health Resources and Services Administration Contract 234–2005-370011C and National Institute of Diabetes and Digestive and Kidney Diseases Grant T35 DK093430.
Conflict of Interest: None.
Authorship: All authors had access to the data and played a role in writing this manuscript.