A history of fatigue and the presence of ascites increases the likelihood that hyponatremia will develop during a patient’s hospital stay for congestive heart failure (CHF).

In a study of 464 CHF patients, researchers at Charles Darwin University, Northern Territory, Australia, found that hyponatremia—defined as a serum sodium level less than 135 mEq/L—developed in 22% of patients during hospitalization. Of these, 44% had normal sodium levels at admission, researchers reported online in BMC Cardiovascular Disorders. (2015;15:88). The study also found that 56% of patients who had hyponatremia on admission continued to be hyponatremic during hospitalization.

A history of fatigue and the presence of ascites were associated with a significant 3.2-fold and 4.1-fold increased odds of developing hyponatremia during hospitalization, respectively. Results also showed that administration of heparin and antibiotics were associated with a significant 3.8-fold and 3.0-fold increased odds, respectively.

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Compared with patients who did not have hyponatremia, those who developed hyponatremia during hospitalization had a significant higher in-hospital mortality rate (29.1% vs. 7.7%) and hospital length of stay (median 11 vs. 8 days).