Kidney Week

Abstract: TH-PO895

Serum Sodium and Bacteremia Risk in Dialysis Patients

Session Information

• Dialysis: Infection
  November 02, 2017 | Location: Hall H, Morial Convention Center
  Abstract Time: 10:00 AM - 10:00 AM

Category: Dialysis

• 610 Dialysis: Infection

Authors

• Rhee, Connie, University of California Irvine, Huntington Beach, California, United States

Connie Rhee,

• You, Amy Seung, University of California, Irvine, Orange, California, United States

Amy Seung You,

• Streja, Elani, Harold Simmons Center for Kidney Disease Research and Epidemiology, Orange, California, United States

Elani Streja,

• Ayus, Juan Carlos, Renal Consultants of Houston, Houston, Texas, United States

Juan Carlos Ayus,

• Moradi, Hamid, University of California, Irvine, Orange, California, United States

Hamid Moradi,

• Brunelli, Steven M., DaVita Clinical Research, Needham, Massachusetts, United States

Steven M. Brunelli,

• Kovesdy, Csaba P., University of Tennessee Health Science Center, Memphis, Tennessee, United States

Csaba P. Kovesdy,

• Nguyen, Danh V., University of California, Irvine, Orange, California, United States

Danh V. Nguyen,

• Kalantar-Zadeh, Kamyar, University of California Irvine, School of Medicine, Orange, California, United States

Kamyar Kalantar-Zadeh,

Background

Hyponatremia is a potential risk factor for infection, which may be due to impairment of IL-17 producing helper T cells that function in host immunity, and concomitant mucosal membrane and cellular edema leading to breakdown of microbial barrier function. While dysnatremia and infection-related mortality are common in dialysis patients, little is known about the association between serum sodium levels and bacteremia in this population.

Methods

Among 823 dialysis patients from the national Biospecimen Registry Grant Program (BioReG) who underwent serum sodium testing over 1/2008-12/2014, we examined the relationship between sodium level and risk of bacteremia using case-mix adjusted Poisson regression models adjusted for age, sex, and race/ethnicity.

Results

In the overall cohort, the mean±SD and minimum-maximum serum sodium values were 138±3mEq/L and 115-154mEq/L, respectively; approximately 10% of all patients experienced one or more bacteremia events during the follow-up period. Patients with both lower sodium <134mEq/L and higher sodium ≥140mEq/L had higher incident rates of bacteremia in case-mix models (ref: 136-<138mEq/L): adjusted IRR [aIRR] 1.99 (1.04-3.81), 0.76 (0.32-1.80), 1.30 (0.73-2.31), 1.83 (1.05-3.18), and 2.07 (1.15-3.72) for sodium levels <134, 134-<136, 138-<140, 140-<142, ≥142mEq/L, respectively.

Conclusion

Both lower and higher serum sodium levels were associated with higher incident rates of bacteremia in dialysis patients. Further studies are needed to determine whether correction of dysnatremia ameliorates infection risk in this population.