全部 标题 作者
关键词 摘要


Advanced age, altered level of consciousness and a new diagnosis of diabetes are independently associated with hypernatreamia in hyperglycaemic crisis

DOI: 10.1186/1472-6823-11-8

Keywords: Hypernatreamia, Hyperglyceamic crisis, prevalence, determinants, South Africa

Full-Text   Cite this paper   Add to My Lib

Abstract:

This was a retrospective review of data for hyperglycaemic crisis admissions in Nelson Mandela Academic Hospital, Mthatha, South Africa. The prevalence of hypernatreamia (uncorrected Serum Sodium at presentation >145 mmol/L) was determined. Hyperosmolality was defined by calculated effective osmolality >320 mosmols/Kg. Multivariate logistic regression was undertaken using variables that were statistically significant in univariate analysis to ascertain those that were independently associated (Odds Ratio (OR) with 95% Confidence Interval (CI)) with hypernatreamia.The prevalence of hypernatreamia in our admissions for hyperglycaemic crisis was 11.7% (n = 32/273 including 171 females and 102 males). All admissions with hypernatreamia met the criteria for hyperosmolality. Age ≥ 60 years (OR = 3.9 95% CI 1.3-12.3; P = 0.018), Altered level of consciousness (OR = 8.8 95% CI 2.3-32.8; P < 0.001) and a new diagnosis of diabetes (OR = 3.7 95%CI 1.2-11.5; P = 0.025) were independently associated with hypernatreamia.The prevalence rate of hypernatreamia in hyperglycaemic admissions was high with all hypernatreamic admissions meeting the criteria for hyperosmolality. Advanced age, altered conscious level and a new diagnosis of diabetes were independently associated with hypernatreamia.Serum sodium measurement is useful in the management of hyperglycaemic crisis as it enables the determination of serum osmolality and anion gap [1]. Hyponatreamia, albeit, a pseudo phenomenon is the predominant serum sodium abnormality reported in hyperglycaemic emergencies [2,3]. While there is considerable literature on hypernatreamia in general [4-7], data on hypernatreamia occurring in the context of hyperglycaemic crisis is limited. Hypernatreamia can have varied aetiology including diabetes insipidus, mineralocorticoid excess, infusions of hypertonic saline and sodium bicarbonate [5]. However, a raised serum sodium level at presentation of hyperglycaemic crisis usually reflects marked dehyd

Full-Text

comments powered by Disqus