Hyponatremia may be a marker of increased risk for dementia, investigators reported at the American Society of Nephrology’s Kidney Week 2022 conference in Orlando, Florida.

In a post hoc analysis of the Systolic Blood Pressure Intervention Trial SPRINT-MIND, 129 of 8541 (1.5%) patients with normal baseline serum sodium experienced hyponatremia at 6 months with a mean serum sodium of 127 meq/L and a total of 324 events.

Hyponatremia was significantly associated with a 2.5- and 2.1-fold increased risk for probable dementia over a mean 4.8 years in an unadjusted model and a fully adjusted model, respectively, Srinivasan Beddhu, MD, of the University of Utah Health in Salt Lake City, reported on behalf of his team. It was not associated with mild cognitive impairment, however. The investigators adjusted for the systolic blood pressure intervention, age, sex, race, cardiovascular disease, congestive heart failure, smoking, body mass index (BMI), and estimated glomerular filtration rate.

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“It is possible that these associations are not causal but incident hyponatremia could be a marker for subsequent risk of dementia and possibly death,” first author Amara Sarwal, MD, told Renal & Urology News in an interview.

“Patients with hyponatremia and other risk factors for dementia might need closer monitoring,” Dr Sarwal said. “Routine cognitive assessments done in a primary care provider’s office and referral to a neurologist when test results are abnormal would be beneficial for such patients.”

Patients with vs without hyponatremia tended to be older White women with lower BMI who were treated with thiazide diuretics and assigned to an intensive systolic blood pressure target of less than 120 mm Hg, according to the investigators.

“Closer laboratory monitoring for hyponatremia when starting thiazides might be needed in this population,” Dr Sarwal said.


Sarwal A, Boucher RE, Abraham N, et al. The association of hyponatremia with cognitive function and all-cause mortality: A post hoc analysis of the systolic blood pressure intervention trial. Presented at: Kidney Week 2022; November 3-6, Orlando, Florida. Abstract FR-PO559.