Kidney Week

Abstract: FR-PO352

Mild Thiazide-Induced Hyponatremia in Hypertensive Patients Is Associated with Increased Mortality Risk

Session Information

• Hypertension, CVD, and the Kidneys: Epidemiology
  October 25, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Hypertension and CVD

• 1602 Hypertension and CVD: Clinical

Authors

• Achinger, Steven, University of South Florida Morsani College of Medicine, Tampa, Florida, United States

Steven Achinger, MD, FASN

• Ayus, Juan Carlos, University of California Irvine, Irvine, California, United States

Juan Carlos Ayus, MD, FASN

• Kumar, Ambuj, University of South Florida Morsani College of Medicine, Tampa, Florida, United States

Ambuj Kumar, MD, MPH

• Tsalatsanis, Athanasios, University of South Florida Morsani College of Medicine, Tampa, Florida, United States

Athanasios Tsalatsanis, PhD

Background

There are over 42 million patients with hypertension taking thiazides in the United States. The goal of this study was to determine if outpatients who start a thiazide diuretic and develop hyponatremia are at increased risk of mortality compared with those who do not develop hyponatremia after starting a thiazide.

Methods

We performed a propensity score matched, retrospective cohort study where all patients aged 40 to 90 years between January 1^st, 2010 and December 31^st, 2021 with essential hypertension and started on a thiazide diuretic were included. The patients with a a serum sodium ≤ 135 mmol/L after initiation of thiazide formed the hyponatremia group and patients with a serum sodium 136-144 mmol/L after initiation of thiazide formed the control group. Data were obtained from the TriNetX research network comprising de-identified electronic medical records of approximately 93 million patients from 76 healthcare organizations worldwide. The primary outcome was one year mortality. The difference in mortality across compared groups was assessed using the log rank test and summarized as hazard ratio along with 95% confidence intervals (CI).

Results

Overall, 256,523 patients met inclusion criteria and after propensity score matching 22,052 patients remained in the hyponatremia and control groups (Table 1). Patients in the hyponatremia cohort had a significantly higher hazard of mortality than patients in control, HR 1.955 (95% CI:1.716, 2.277, p<0.001) (Figure 1).

Conclusion

Patients who develop hyponatremia (serum sodium ≤ 135 mmol/L) following initiation of a thiazide diuretic have a higher risk of mortality compared with those who do not develop hyponatremia following initiation of a thiazide diuretic.