PMID- 27478591
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20160801
LR  - 20240325
IS  - 2048-8505 (Print)
IS  - 2048-8513 (Electronic)
IS  - 2048-8505 (Linking)
VI  - 9
IP  - 4
DP  - 2016 Aug
TI  - The utility and accuracy of four equations in predicting sodium levels in 
      dysnatremic patients.
PG  - 530-9
LID - 10.1093/ckj/sfw034 [doi]
AB  - BACKGROUND: Improper correction of hyponatremia can cause severe complications, 
      including osmotic demyelination syndrome (ODS). The Adrogue-Madias equation (AM), 
      the Barsoum-Levine (BL) equation, the Electrolyte Free Water Clearance (EFWC) 
      equation and the Nguyen-Kurtz (NK) equation are four derived equations based on 
      the empirically derived Edelman equation for predicting sodium at a later time 
      (Na2) from a known starting sodium (Na1), fluid/electrolyte composition and input 
      and output volumes. METHODS: Our retrospective study included 43 data points from 
      31 mostly hyponatremic patients. We calculated Na2 based on five sets of rules 
      that were progressively more precisely calculated. Sets A-D included all 31 
      patients and 43 data points and set E was based on 15 patients and 27 data 
      points. RESULTS: The root mean square error was calculated and found to be 
      between 4.79 and 6.37 mmol/L (mEq/L) for all sets. Bland-Altman analysis showed 
      high variability and discrepancies between the predicted and actual Na2. 
      CONCLUSIONS: Like similar studies in hypernatremic patients, the data suggest 
      that hyponatremic modeling equations are not reliably accurate in predicting Na2 
      from Na1 and available clinical data regarding sodium, potassium and fluid 
      balance over longer time frames (12-30 h). Our study was retrospective and was 
      done in an inpatient setting and thus was subject to limitations and laboratory 
      measurement variability, but showed that all four equations are not able to 
      reliably predict Na2 from Na1 and inputs across a 12-30 h period.
FAU - Hanna, Ramy Magdy
AU  - Hanna RM
AD  - Division of Nephrology, Department of Medicine , Cedars-Sinai Medical Center , 
      8700 Beverly Blvd, Los Angeles, CA , USA.
FAU - Yang, Wan-Ting
AU  - Yang WT
AD  - Division of Nephrology, Department of Medicine , Kaiser Permanente , Fontana, CA 
      , USA.
FAU - Lopez, Eduardo A
AU  - Lopez EA
AD  - Division of Nephrology, Department of Medicine , Kaiser Permanente , Panorama 
      City, CA , USA.
FAU - Riad, Joseph Nabil
AU  - Riad JN
AD  - Division of Nephrology, Department of Medicine , UCLA David Geffen School of 
      Medicine , Los Angeles, CA , USA.
FAU - Wilson, James
AU  - Wilson J
AD  - Division of Nephrology, Department of Medicine , UCLA David Geffen School of 
      Medicine , Los Angeles, CA , USA.
LA  - eng
PT  - Journal Article
DEP - 20160524
PL  - England
TA  - Clin Kidney J
JT  - Clinical kidney journal
JID - 101579321
PMC - PMC4957716
OTO - NOTNLM
OT  - clearance
OT  - hyponatremia
OT  - intensive care
OT  - nutrition
OT  - vasopressin
EDAT- 2016/08/02 06:00
MHDA- 2016/08/02 06:01
PMCR- 2016/05/24
CRDT- 2016/08/02 06:00
PHST- 2015/10/23 00:00 [received]
PHST- 2016/03/11 00:00 [accepted]
PHST- 2016/08/02 06:00 [entrez]
PHST- 2016/08/02 06:00 [pubmed]
PHST- 2016/08/02 06:01 [medline]
PHST- 2016/05/24 00:00 [pmc-release]
AID - sfw034 [pii]
AID - 10.1093/ckj/sfw034 [doi]
PST - ppublish
SO  - Clin Kidney J. 2016 Aug;9(4):530-9. doi: 10.1093/ckj/sfw034. Epub 2016 May 24.