Associations of serum sodium levels with mortality in very elderly acute kidney injury patients
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Abstract Background: Patients suffering from acute kidney injury (AKI) have been associated with impaired sodium. However, studies on the association of dysnatremia with all-cause mortality risk in AKI patients are particularly lacking. We examined the relationship between different levels of serum sodium and mortality among very elderly patients with AKI. Methods: We retrospectively enrolled very elderly patients (≥ 75 years) from Chinese PLA General Hospital from 2007, to 2018. All-cause mortality was examined according to eight predefined sodium levels: <130.0 mmol/L, 130.0–134.9 mmol/L, 135.0–137.9 mmol/L, 138.0–141.9 mmol/L, 142.0–144.9 mmol/L, 145.0–147.9 mmol/L, 148.0–151.9 mmol/L, and ≥152.0 mmol/L. We estimated the risk of all-cause mortality using a multivariable adjusted Cox proportional hazard model, with a normal serum potassium level of 135.0–137.9 mmol/L as a reference. Results: In total, 744 geriatric patients were suitable for the final evaluation. Among them, 260 (34.9%) died within 90 days; during the 1-year follow-up, 5 patients were lost to follow-up, and 383 (51.8%) died. After 90 days, the mortality rates in the eight strata were 36.1, 27.8, 19.6, 24.4, 30.7, 48.6, 52.8, and 57.7%, respectively. In the multivariable adjusted analysis, patients with sodium levels <130.0 mmol/L [hazard ratio (HR): 2.247; 95% confidence interval (CI): 1.117–4.521], from 142.0 to 144.9 mmol/L (HR: 1.964; 95% CI: 1.100–3.508), from 145.0 to 147.9 mmol/L (HR: 2.942; 95% CI: 1.693–5.114), from 148.0 to 151.9 mmol/L (HR: 3.455; 95% CI: 2.009–5.944), and ≥152.0 mmol/L (HR: 3.587; 95% CI: 2.151–5.983) had an increased risk of all-cause mortality. After 1 year, the mortality rates in the eight strata were 58.3, 47.8, 33.7, 38.9, 45.5, 64.3, 69.4, and 78.4%, respectively. In the multivariable adjusted analysis, patients with sodium levels <130.0 mmol/L (HR: 1.944; 95% CI: 1.125–3.360), from 142.0 to 144.9 mmol/L (HR: 1.681; 95% CI: 1.062–2.660), from 145.0 to 147.9 mmol/L (HR: 2.631; 95% CI: 1.683–4.112), from 148.0 to 151.9 mmol/L (HR: 2.411; 95% CI: 1.552–3.744), and ≥152.0 mmol/L (HR: 3.037; 95% CI: 2.021–4.563) had an increased risk of all-cause mortality. Conclusion: Sodium levels outside the interval of 130.0–141.9 mmol/L were associated with increased risks of 90-day mortality and 1-year mortality in very elderly AKI patients.
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Associations of serum sodium levels with mortality in very elderly acute kidney injury patients | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Associations of serum sodium levels with mortality in very elderly acute kidney injury patients Qinglin Li, Liang Pan, Zhi Mao, Hongjun Kang, Feihu Zhou This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-16898/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background: Patients suffering from acute kidney injury (AKI) have been associated with impaired sodium. However, studies on the association of dysnatremia with all-cause mortality risk in AKI patients are particularly lacking. We examined the relationship between different levels of serum sodium and mortality among very elderly patients with AKI. Methods: We retrospectively enrolled very elderly patients (≥ 75 years) from Chinese PLA General Hospital from 2007, to 2018. All-cause mortality was examined according to eight predefined sodium levels: <130.0 mmol/L, 130.0–134.9 mmol/L, 135.0–137.9 mmol/L, 138.0–141.9 mmol/L, 142.0–144.9 mmol/L, 145.0–147.9 mmol/L, 148.0–151.9 mmol/L, and ≥152.0 mmol/L. We estimated the risk of all-cause mortality using a multivariable adjusted Cox proportional hazard model, with a normal serum potassium level of 135.0–137.9 mmol/L as a reference. Results: In total, 744 geriatric patients were suitable for the final evaluation. Among them, 260 (34.9%) died within 90 days; during the 1-year follow-up, 5 patients were lost to follow-up, and 383 (51.8%) died. After 90 days, the mortality rates in the eight strata were 36.1, 27.8, 19.6, 24.4, 30.7, 48.6, 52.8, and 57.7%, respectively. In the multivariable adjusted analysis, patients with sodium levels <130.0 mmol/L [hazard ratio (HR): 2.247; 95% confidence interval (CI): 1.117–4.521], from 142.0 to 144.9 mmol/L (HR: 1.964; 95% CI: 1.100–3.508), from 145.0 to 147.9 mmol/L (HR: 2.942; 95% CI: 1.693–5.114), from 148.0 to 151.9 mmol/L (HR: 3.455; 95% CI: 2.009–5.944), and ≥152.0 mmol/L (HR: 3.587; 95% CI: 2.151–5.983) had an increased risk of all-cause mortality. After 1 year, the mortality rates in the eight strata were 58.3, 47.8, 33.7, 38.9, 45.5, 64.3, 69.4, and 78.4%, respectively. In the multivariable adjusted analysis, patients with sodium levels <130.0 mmol/L (HR: 1.944; 95% CI: 1.125–3.360), from 142.0 to 144.9 mmol/L (HR: 1.681; 95% CI: 1.062–2.660), from 145.0 to 147.9 mmol/L (HR: 2.631; 95% CI: 1.683–4.112), from 148.0 to 151.9 mmol/L (HR: 2.411; 95% CI: 1.552–3.744), and ≥152.0 mmol/L (HR: 3.037; 95% CI: 2.021–4.563) had an increased risk of all-cause mortality. Conclusion: Sodium levels outside the interval of 130.0–141.9 mmol/L were associated with increased risks of 90-day mortality and 1-year mortality in very elderly AKI patients. Critical Care & Emergency Medicine Serum sodium acute kidney injury very elderly mortality Figures Figure 2 Figure 3 Background Acute kidney injury (AKI) is a common clinical acute critical illness that is frequently encountered in the elderly population. [ 1 – 3 ] The disorder is generally characterized by an abrupt deterioration in renal function (RF) that disrupts metabolic, electrolyte and fluid homeostasis over a period of hours to days. [ 4 – 6 ] Aging kidneys undergoing structural and functional changes that decrease autoregulatory capacity, systemic vasculature, and the immunological system render the elderly population highly susceptible to AKI. [ 7 , 8 ] Previous studies of AKI in the elderly population mostly examined all-cause mortality, renal prognosis, or cardiovascular events. [ 9 , 10 ] However, little work has been done on investigating electrolyte imbalances in very elderly AKI patients, such as dysnatremia and its association with mortality. [ 11 ] The kidneys play a central role in sodium homeostasis, and their functional decline leads to electrolyte disorders. [ 12 ] Recently, Gao reported that compared with the reference group (136.0–144.9 mmol/L), AKI patients at the time of hospital admission with hyponatremia (< 136.0 mmol/L) or hypernatremia (≥ 145.0 mmol/L) had higher 90-day mortality rates. [ 12 ] However, the independent or synergistic prognostic effects of abnormal serum sodium levels remain less well studied among very elderly AKI patients. In addition, the normal ranges of serum sodium levels that are applicable to such patients are still unknown. Therefore, identifying the clinically significant normal ranges of serum sodium is an important issue for clinicians when making decisions regarding very elderly AKI patients with dysnatremia. Materials And Methods This was a retrospective observational study conducted at the Chinese PLA General Hospital National Clinical Research Center for Geriatric Diseases (Beijing, China). All patients aged ≥ 75 years with normal renal function who were admitted between January 2007 and December 2018 were enrolled. The study design was approved by the Clinical Ethics Committee of the Chinese PLA General Hospital. All admissions were screened and evaluated for AKI and categorized according to the Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Demographic and basic data were obtained from the medical records. Serum sodium levels at the time of AKI diagnosis were recorded. Other laboratory data of interest included baseline serum creatinine (Scr) level, the Scr level at the time of AKI diagnosis, and the levels of blood urea nitrogen (BUN), uric acid, blood glucose (BG), electrolytes (K, Ca, P, and Mg), C-reactive protein (CRP), albumin, prealbumin, and hemoglobin. The exclusion criteria were as follows: patients who had been previously diagnosed with chronic kidney disease (CKD), a hospital stay < 48 h, patients with no Scr data or only one Scr test, patients with insufficient medical records, and patients who died within 48 h of admission. Definitions The 2012 KDIGO-defined Scr criteria were used to identify and classify AKI. [ 13 ] The CKD Epidemiology Collaboration method was used to calculate the baseline estimated glomerular filtration rate (eGFR). [ 14 ] The baseline Scr level was the most recent measure taken in the 1–3 months before admission for AKI. [ 15 ] Sepsis was defined according to the Surviving Sepsis Campaign Bundle: 2018 update. [ 16 ] The normal sodium reference range (135.0–145.0 mmol/L) was divided into three intervals. Furthermore, five intervals outside the normal sodium reference range were defined: one interval contained patients with a serum sodium level below 130.0 mmol/L, one contained those with a serum sodium level from 130.0 mmol/L to 134.9 mmol/L, one contained those with a serum sodium level from 145.0 mmol/L to 147.9 mmol/L, one contained those with a serum sodium level from 148.0 mmol/L to 151.9 mmol/L and last, one interval contained patients with a serum sodium above 152.0 mmol/L. Thus, this study contains eight sodium intervals, where the reference interval was defined as a sodium level from 135.0 to 137.9 mmol/L based on the analysis, which confirmed that the lowest mortality risk was found in this range (Table 1 ). Table 1 Demographic data stratification according to serum sodium levels Characteristic AKI patients n = 744 < 130.0 mmol/L n = 36 130.0–134.9 mmol/L n = 115 135.0–137.9 mmol/L n = 102 138.0–141.9 mmol/L n = 164 142.0–144.9 mmol/L n = 88 145.0–147.9 mmol/L n = 70 148.0–151.9 mmol/L n = 72 ≥ 152.0 mmol/L n = 97 P- value Age (years) 88 (84–91) 87 (82–94) 87 (84–91) 87 (82–91) 87 (83–90) 87 (84–90) 90 (86–92) 89 (85–92) 89 (85–92) 0.003 Male sexr 701 (94.2) 30 (83.3) 108 (93.9) 98 (96.1) 150 (91.5) 86 (97.7) 67 (95.7) 70 (97.2) 92 (94.8) 0.085 BMI (kg/m 2 ) 23.0 ± 3.1 23.2 ± 2.7 23.1 ± 3.2 23.5 ± 3.0 23.2 ± 3.4 22.9 ± 3.1 22.6 ± 3.3 22.5 ± 2.7 22.6 ± 2.9 0.256 Comorbidity Coronary disease 565 (75.9) 24 (66.7) 94 (81.7) 85 (83.3) 120 (73.2) 60 (68.2) 54 (77.1) 58 (80.6) 70 (72.2) 0.097 Hypertension 546 (73.4) 28 (77.8) 83 (72.2) 80 (78.4) 121 (73.8) 67 (76.1) 53 (75.7) 52 (72.2) 62 (63.9) 0.448 COPD 511 (68.7) 20 (55.6) 79 (68.7) 69 (67.6) 111 (67.7) 59 (67.0) 52 (74.3) 53 (73.6) 68 (70.1) 0.654 Diabetes 283 (38.0) 10 (27.8) 44 (38.3) 44 (43.1) 64 (39.0) 35 (39.8) 19 (27.1) 25 (34.7) 42 (43.3) 0.340 Baseline Scr (µmol/L) 72.0 (60.0–82.0) 70.0 (64.0–80.0) 72.0 (58.0–81.0) 78.0 (62.0–86.0) 76.0 (62.0–84.0) 72.0 (63.0–83.0) 69.0 (57.0–80.0) 67.0 (56.0–80.0) 66.0 (56.0–78.0) < 0.001 Baseline eGFR (mL/min/1.73 m 2 ) 78.7 (72.2–85.4) 78.1 (72.8–85.7) 79.0 (73.8–84.8) 76.8 (69.5–83.2) 77.7 (70.2–84.8) 78.6 (72.2–85.7) 81.1 (72.0–85.7) 80.4 (74.8–86.8) 80.7 (75.7–87.1) 0.056 Etiology of AKI Sepsis 312 (41.9) 19 (52.8) 34 (29.6) 32 (31.4) 59 (36.0) 35 (39.8) 38 (54.3) 39 (54.2) 56 (57.7) < 0.001 Hypovolemia 159 (21.4) 6 (16.7) 25 (21.7) 30 (29.4) 30 (18.3) 19 (21.6) 16 (22.9) 17 (23.6) 16 (16.5) 0.427 Cardiovascular events 111 (14.9) 7 (19.4) 25 (21.7) 15 (14.7) 23 (14.0) 14 (15.9) 10 (14.3) 8 (11.1) 9 (9.3) 0.311 Nephrotoxicity 89 (12.0) 3 (8.3) 14 (12.2) 10 (9.8) 26 (15.9) 13 (14.8) 5 (7.1) 6 (8.3) 12 (12.4) 0.477 Surgery 49 (6.6) 1 (2.8) 8 (7.0) 13 (12.7) 21 (12.8) 4 (4.5) 1 (1.4) 1 (1.4) 0 < 0.001 Others 24 (3.2) 0 9 (7.8) 2 (2.0) 5 (3.0) 3 (3.4) 0 1 (1.4) 4 (4.1) 0.044 Clinical conditions MAP (mmHg) 78 ± 14 80 ± 14 76 ± 13 79 ± 15 81 ± 12 79 ± 15 75 ± 14 75 ± 15 76 ± 16 0.012 Oliguria 46 (6.2) 5 (13.9) 11 (9.6) 2 (2.0) 9 (5.5) 4 (4.5) 4 (5.7) 6 (8.3) 5 (5.2) 0.174 MV 298 (40.1) 7 (19.4) 44 (38.3) 22 (21.6) 37 (22.6) 34 (38.6) 42 (60.0) 50 (69.4) 62 (63.9) < 0.001 Pharmacotherapy ACEIs/ARBs 414 (55.6) 19 (52.8) 60 (52.2) 66 (64.7) 98 (59.8) 49 (55.7) 40 (57.1) 37 (51.4) 45 (46.4) 0.242 Beta-blockers 336 (45.2) 17 (47.2) 51 (44.3) 48 (47.1) 81 (49.4) 41 (46.6) 30 (42.9) 30 (41.7) 38 (39.2) 0.845 Calcium channel blockers 306 (41.1) 16 (44.4) 45 (39.1) 50 (49.0) 69 (42.1) 40 (45.5) 27 (38.6) 28 (38.9) 31 (32.0) 0.386 Diuretics 602 (80.9) 29 (80.6) 88 (76.5) 85 (83.3) 130 (79.3) 74 (84.1) 59 (84.3) 61 (84.7) 76 (78.4) 0.745 Laboratory parameters Scr (µmol/L) 128.4. (115.0–145.0) 131.5 (116.3–145.0) 125.0 (109.0–144.0) 128.5 (115.0–144.3) 126.6 (115.3–142.2) 124.7.0 (115.0–150.0) 131.6 (113.8–145.1) 136.0 (120.9–156.9) 135.5 (116.6–149.3) 0.036 Peak Scr (µmol/L) 144.0 (124.0–206.4) 140.1 (123.3–278.5) 136.1 (116.9–211.7) 138.0 (122.0–180.1) 137.0 (123.1–166.0) 148.5 (122.8–207.6) 171.0 (126.0–237.6) 172.5 (131.3–267.0) 170.0 (139.1–234.6) < 0.001 BUN (mmol/L) 12.7 (8.9–20.7) 11.0 (9.4–17.0) 11.4 (8.8–14.7) 9.6 (7.4–14.9) 10.3 (7.5–13.8) 12.0 (8.4–17.6) 17.1 (9.4–25.5) 21.1 (15.1–28.4) 21.6 (16.6–36.8) < 0.001 Peak BUN (mmol/L) 17.5 (10.7–32.9) 20.0 (10.0–36.6) 14.7 (10.0–26.7) 12.8 (9.0–20.5) 11.4 (8.8–22.2) 15.9 (9.6–27.3) 23.8 (13.1–34.2) 30.3 (21.4–41.6) 32.5 (21.3–42.9) < 0.001 Uric acid (mmol/L) 366.5 (291.3–468.3) 355.5 (255.4–421.3) 356.4 (283.6–485.0) 369.1 (287.9–448.2) 350.5 (281.6–428.5) 362.9 (267.4–468.9) 404.0 (316.8–538.8) 363.7 (308.3–509.3) 417.0 (336.9–547.0) 0.111 BG (mmol/L) 7.4 (5.8–10.3) 8.3 (6.2–10.3) 7.6 (5.8–11.2) 7.7 (5.9–9.9) 6.9 (5.3–9.4) 6.4 (5.2–8.6) 7.6 (6.1–9.4) 7.9 (6.4–10.1) 9.3 (7.0–12.7) < 0.001 K (mmol/L) 4.2 (3.8–4.7) 4.5 (4.0–4.9) 4.3 (3.9–4.9) 4.1 (3.8–4.5) 4.1 (3.8–4.6) 4.1 (3.8–4.7) 4.0 (3.7–4.8) 4.3 (3.9–4.9) 4.1 (3.7–4.4) 0.165 Na (mmol/L) 140.0 (136.0–147.0) 127.0 (124.0–128.0) 132.0 (131.0–134.0) 136.0 (136.0–137.0) 139.0 (138.0–140.0) 143.0 (142.0–144.0) 146.0 (145.0–147.0) 149.0 (148.0–150.0) 157.0 (154.0–161.0) < 0.001 Ca (mmol/L) 2.2 (2.1–2.4) 2.2 (2.0–2.3) 2.2 (2.1–2.4) 2.2 (2.1–2.3) 2.2 (2.1–2.3) 2.2 (2.1–2.3) 2.2 (2.0–2.4) 2.2 (2.0–2.3) 2.3 (2.1–2.5) 0.072 P (mmol/L) 1.2 (0.9–1.4) 1.1 (1.0–1.4) 1.1 (0.9–1.4) 1.1 (0.9–1.4) 1.2 (1.0–1.5) 1.2 (1.1–1.4) 1.2 (1.0–1.5) 1.2 (0.9–1.4) 1.2 (1.0–1.5) 0.062 Mg (mmol/L) 0.9 (0.8–1.0) 0.8 (0.7–0.9) 0.9 (0.8–1.0) 0.9 (0.8–1.0) 0.9 (0.8–1.0) 0.9 (0.8–1.0) 0.9 (0.8–1.0) 1.0 (0.8–1.1) 1.0 (0.9–1.1) < 0.001 CRP (mmol/L) 4.2 (1.9–9.6) 4.7 (1.9–11.0) 4.9 (2.3–10.0) 3.3 (1.6–9.5) 3.2 (1.6–7.3) 3.6 (1.6–8.4) 5.6 (2.4–13.2) 5.6 (2.1–11.0) 4.4 (2.3–9.9) 0.112 Albumin (g/L) 34.2 ± 5.6 33.4 ± 7.3 35.1 ± 5.8 35.3 ± 5.5 35.5 ± 4.9 34.4 ± 5.2 33.8 ± 5.5 31.8 ± 5.7 32.2 ± 4.9 < 0.001 Prealbumin (g/L) 176.0 (134.0–229.0) 160.0 (115.0–219.0) 171 (145–208) 198 (148–248) 205 (155–259) 170 (134–230) 163 (125–226) 159 (122–226) 156 (134–205) 0.003 Hemoglobin (g/L) 112 ± 22 115 ± 20 113 ± 21 117 ± 21 115 ± 23 112 ± 21 106 ± 21 105 ± 24 108 ± 23 < 0.001 AKI Stage < 0.001 1 323 (43.4) 15 (41.7) 57 (49.6) 58 (56.9) 95 (57.9) 42 (47.7) 22 (31.4) 14 (19.4) 20 (20.6) 2 190 (25.5) 9 (25.0) 27 (23.5) 22 (21.6) 38 (23.2) 18 (20.5) 18 (25.7) 25 (34.7) 33 (34.0) 3 231 (31.0) 12 (33.3) 31 (27.0) 22 (21.6) 31 (18.9) 28 (31.8) 30 (42.9) 33 (45.8) 44 (45.4) Outcomes RRT 4 (0.5) 1 (2.8) 2 (1.7) 1 (1.0) 0 0 0 0 0 0.236 90-day mortality 260 (34.9) 13 (36.1) 32 (27.8) 20 (19.6) 40 (24.4) 27 (30.7) 34 (48.6) 38 (52.8) 56 (57.7) < 0.001 1-year mortality 383 (51.8) 21 (58.3) 54 (47.8) * 34 (33.7) # 63 (38.9) * 40 (45.5) 45 (64.3) 50 (69.4) 76 (78.4) < 0.001 Outcomes The outcome of the study was all-cause mortality within 90 days and within 1 year after AKI diagnosis. Statistical analysis Continuous variables are presented as the mean ± standard deviation for parametric variables or as the median with interquartile range (with 25th and 75th percentiles) for nonparametric variables. Categorical variables are presented as numbers (n) or percentages (%). Group comparisons were conducted using ANOVA or the Kruskal–Wallis H test for continuous variables and Pearson’s chi-square or Fisher’s exact test for categorical variables. Prognostic survival factors were identified using the Cox proportional hazards regression model. Survival probability was estimated using the Kaplan–Meier method for the eight potassium intervals, and curves were compared among groups using the log-rank test. A P -value < 0.05 was considered significant. Statistical analyses were performed using SPSS version 21.0 for Windows software (SPSS Inc., Chicago, IL, USA). Results Study population In the period 2007–2018, a total of 3861 very elderly patients (aged ≥ 75 years) were hospitalized at the National Clinical Research Center for Geriatric Diseases, 760 of whom developed AKI during hospitalization. Of these patients, 13 were excluded because of a length of hospital stay of less than 48 hours, 3 were excluded because of missing data that was required for this study, and 744 AKI patients were suitable for the final analysis. The median age of the 744 participants was 88 years, and the majority (701, 94.2%) were male. Among all patients, 260 (34.9%) died within 90 days. During the 1-year follow-up, 5 patients were lost, and 383 (51.8%) died. General Conditions And Clinical Characteristics According To Sodium Levels A summary of the baseline characteristics of the study population is provided in Table 1. The overall median serum sodium level when AKI was diagnosed was 140.0 mmol/L (136.0–147.0 mmol/L). Thirty-six patients were in the low sodium group (< 130.0 mmol/L), 115 in the sodium group 130.0–134.9 mmol/L, 102 in the sodium group 135.0–137.9 mmol/L, 164 in the sodium group 138.0–141.9 mmol/L, 88 in the sodium group 142.0–144.9 mmol/L, 70 in the sodium group 145.0–147.9 mmol/L, 72 in the sodium group 148.0–151.9 mmol/L, and 97 in the sodium group ≥ 152.0 mmol/L. Age, baseline Scr, sepsis, surgery, mean aortic pressure, need for mechanical ventilation, Scr, peak Scr, BUN, peak BUN, BG, Mg, prealbumin, albumin, hemoglobin, and AKI stage differed significantly among the 8 groups at the time of AKI diagnosis. Significant interactions were also observed between serum sodium levels and both 90-day mortality ( P < 0.001) and 1-year mortality ( P < 0.001). The 90-day mortality rates in the eight sodium interval groups from the lowest (< 130.0 mmol/L) to the highest (≥ 152.0 mmol/L) were 36.1, 27.8, 19.6, 24.4, 30.7, 48.6, 52.8, and 57.7%, respectively. The 1-year mortality rates in the eight strata were 58.3, 47.8, 33.7, 38.9, 45.5, 64.3, 69.4, and 78.4%, respectively. Survival analysis Of the patients, 260 (34.9%) died during the 90-day follow-up. Survival curves for 90-day all-cause mortality across categories of serum sodium are presented in Fig. 1 . As shown in Table 2 , among all the deaths from AKI, 5.0% of the patients had sodium levels < 130.0 mmol/L, 12.3% had sodium levels from 130.0 to 134.9 mmol/L, 7.7% had sodium levels from 135.0 to 137.9 mmol/L, 15.4% had sodium levels from 138.0 to 141.9 mmol/L, 10.4% had sodium levels from 142.0 to 144.9 mmol/L, 13.1% had sodium levels from 145.0 to 147.9 mmol/L, 14.6% had sodium levels from 148.0 to 151.9 mmol/L, and 21.5% had sodium levels ≥ 152.0 mmol/L. Table 2 Association of categories of serum sodium levels with 90-day and 1-year mortality Characteristic 90-day outcomes 1-year outcomes Nonsurvivors n = 260 (34.9) Survivors n = 484 (65.1) P Nonsurvivors n = 383 (51.8) Survivors n = 356 (48.2) P Sodium levels (mmol/L) < 0.001 < 0.001 < 130.0 13 (5.0) 23 (4.8) 21 (5.5) 15 (4.2) 130.0–134.9 32 (12.3) 83 (17.1) 54 (14.1) 59 (16.6) 135.0–137.9 20 (7.7) 82 (16.9) 34 (8.9) 67 (18.8) 138.0–141.9 40 (15.4) 124 (25.6) 63 (16.4) 99 (27.8) 142.0–144.9 27 (10.4) 61 (12.6) 40 (10.4) 48 (13.5) 145.0–147.9 34 (13.1) 36 (7.4) 45 (11.7) 25 (7.0) 148.0–151.9 38 (14.6) 34 (7.0) 50 (13.1) 22 (6.2) ≥ 152.0 56 (21.5) 41 (8.5) 76 (19.8) 21 (5.9) Table 3 Multivariate Cox proportional hazard model analysis of risk factors for mortality Risk factor 90-day mortality 1-year mortality HR 95%CI P HR 95%CI P MAP 0.960 0.951–0.968 < 0.001 0.979 0.972–0.986 < 0.001 Albumin – – – 0.906 0.887–0.924 < 0.001 Sodium levels (mmol/L) < 0.001 < 0.001 135.0–137.9 Reference Reference – Reference Reference – < 130.0 2.247 1.117–4.521 0.023 1.944 1.125–3.360 0.017 130.0–134.9 1.442 0.825–2.522 0.199 1.436 0.935–2.207 0.099 138.0–141.9 1.438 0.840–2.463 0.186 1.428 0.938–2.173 0.097 142.0–144.9 1.964 1.100–3.508 0.022 1.681 1.062–2.660 0.027 145.0–147.9 2.942 1.693–5.114 < 0.001 2.631 1.683–4.112 < 0.001 148.0–151.9 3.455 2.009–5.944 < 0.001 2.411 1.552–3.744 < 0.001 ≥ 152.0 3.587 2.151–5.983 < 0.001 3.037 2.021–4.563 < 0.001 During the 1-year follow-up, 5 patients were lost, and 383 (51.8%) died. Survival curves for 1-year all-cause mortality across categories of serum sodium are presented in Fig. 2 . Among all the deaths from AKI, 5.5% of the patients had sodium levels < 130.0 mmol/L, 14.1% had sodium levels from 130.0 to 134.9 mmol/L, 8.9% had sodium levels from 135.0 to 137.9 mmol/L, 16.4% had sodium levels from 138.0 to 141.9 mmol/L, 10.4% had sodium levels from 142.0 to 144.9 mmol/L, 11.7% had sodium levels from 145.0 to 147.9 mmol/L, 13.1% had sodium levels from 148.0 to 151.9 mmol/L, and 19.8% had sodium levels ≥ 152.0 mmol/L. In the multivariable adjusted analysis, patients with sodium levels < 130.0 mmol/L [hazard ratio (HR): 2.247; 95% confidence interval (CI): 1.117–4.521; P = 0.023], from 142.0 to 144.9 mmol/L (HR: 1.964; 95% CI: 1.100–3.508; P = 0.022), from 145.0 to 147.9 mmol/L (HR: 2.942; 95% CI: 1.693–5.114; P < 0.001), from 148.0 to 151.9 mmol/L (HR: 3.455; 95% CI: 2.009–5.944; P < 0.001), and ≥ 152.0 mmol/L (HR: 3.587; 95% CI: 2.151–5.983; P < 0.001) had relatively higher 90-day mortality rates. Significant interactions were also observed between serum sodium levels and 1-year mortality: patients with sodium levels < 130.0 mmol/L (HR: 1.944; 95% CI: 1.125–3.360; P = 0.017), from 142.0 to 144.9 mmol/L (HR: 1.681; 95% CI: 1.062–2.660; P = 0.027), from 145.0 to 147.9 mmol/L (HR: 2.631; 95% CI: 1.683–4.112; P < 0.001), from 148.0 to 151.9 mmol/L (HR: 2.411; 95% CI: 1.552–3.744; P < 0.001), and ≥ 152.0 mmol/L (HR: 3.037; 95% CI: 2.021–4.563; P < 0.001) had relatively higher 1-year mortality rates. Discussion Sodium is the main electrolyte responsible for serum osmolarity. [ 17 ] Patients suffering from AKI have impaired sodium homeostasis. Dysnatremia is the most common electrolyte abnormality in clinical practice, as our study found (52.4%). [ 11 ] No studies have independently or simultaneously investigated the prognostic role of such electrolytes among very elderly patients with AKI. This study analyzed the 90-day mortality and 1-year mortality risks in relation to different serum sodium intervals in very elderly AKI patients. It was not surprising that sodium levels outside the normal range (Na 145.0 mmol/L) were associated with an increased mortality risk; it was unexpected that one normal sodium level (Na: 142.0–144.9 mmol/L) was also associated with a significantly increased mortality risk in AKI patients. In the elderly population, the incidence of electrolyte imbalance is expected to be higher because of organ decline, decreased physiologic reserves, frailty, and the higher prevalence of disability and functional impairment. [ 18 – 20 ] Kidneys are responsible for maintaining water homeostasis, and AKI could magnify the effect of dysnatremia on the clinical consequences. Normal ranges of serum sodium levels within 135.0–145.0 mmol/L used in clinical settings are determined mainly based on healthy subjects, and whether these values are applicable to elderly patients with complex comorbidities is still unknown. [ 21 ] Through interfering with tubular functions, AKI disturbs the physiological regulation of electrolyte homeostasis, which could be more prominent in the elderly population. Previous studies have consistently reported that electrolyte imbalances, including dysnatremia and dyskalemia, are associated with worse in-hospital outcomes. Furthermore, the adverse impact of dysnatremia on clinical outcomes might be independent of the presence of initial AKI. Hypernatremia is characterized by a deficit of total body water relative to the total body sodium level and is defined as a serum sodium concentration exceeding 145 mmol/L. [ 22 ] Hypernatremia in the geriatric population is a common disorder associated with significant mortality. Older people are predisposed to developing hypernatremia because of age-related physiologic changes such as decreased thirst drive, impaired urinary concentrating ability, and reduced total body water. [ 23 ] Medications may also exacerbate this predisposition. Clinical data reported that hypernatremia is present in approximately 2.0% of patients older than 65 years but in almost 4.8% of those older than 75 years admitted to the hospital. [ 24 ] In a retrospective study involving 8,441 older patients admitted to the ICU, approximately 3.6% had hypernatremia on admission, and 15.3% developed hypernatremia during hospitalization; [ 25 ] the mortality rate in those admitted with hypernatremia was approximately 33.3%, while patients without hypernatremia had a mortality rate of 18.1%. [ 25 ] If patients had normal serum sodium levels on admission and developed mild hypernatremia (145.0–150.0 mmol/L) or moderate to severe hypernatremia (> 150.0 mmol/L) in the ICU, the mortality rates increased to 29.5% and 46.2%, respectively. [ 25 ] Other studies have confirmed these findings: mortality increases with increasing serum sodium level, and even mild hypernatremia is associated with significant mortality in hospitalized elderly patients, even after accounting for confounders. [ 25 – 27 ] Hyponatremia, defined as a serum sodium concentration below 135 mmol/L, is the most common electrolyte problem seen in hospitalized patients. [ 22 ] Advanced age is an independent risk factor for the development of hyponatremia due to the decreased ability of the body to handle stresses related to salt and water balance. Moreover, drugs such as thiazides and nonsteroidal anti-inflammatory agents commonly used in this age group contribute to a decreased renal ability to excrete free water. Critically ill patients also demonstrate impaired renal capacity to excrete free water. Hyponatremia has been observed in 14.5–37.9% of patients upon hospital admission, [ 28 – 30 ] while rates of hospital-acquired hyponatremia range from 11.0 to 38.2%. [ 29 , 31 , 32 ] Mortality rates vary significantly based on the population studied, and in several studies, hyponatremia has been associated with an increased risk of death. [ 28 – 32 ] The treatment and prevention of AKI remains a major challenge for intensive care physicians and nephrologists. When managing severe AKI, whether to provide renal replacement therapy (RRT) and, if it is needed, when to initiate it are unclear. It is widely accepted that if there are life-threatening complications of AKI, such as hyperkalemia or metabolic acidosis, RRT should be initiated immediately. However, in the absence of such complications, the appropriate timing of the initiation of RRT remains unclear. A significant interaction between serum sodium levels and mortality was observed in our study ( P interaction: <0.001 for 90-day mortality and < 0.001 for 1-year mortality). Across different sodium strata, higher and lower serum sodium levels were both associated with an increased risk of mortality among patients with AKI. Hypernatremia has been poorly assessed in AKI, probably because according to a previous report, more AKI patients suffer from hyponatremia (Na + 145 mmol/L) (27.0% vs 5.7%) when admitted to the ICU. [ 33 ] However, the percentage of patients with hypernatremia was 32.1% compared with 20.3% of the patients with hyponatremia in our study. Both hyponatremia and hypernatremia can have direct adverse effects on the function of various organs, including the brain, heart, and musculoskeletal system, and subsequently increase mortality. Dysnatremia may be a potential target for correction for clinicians. However, whether correcting dysnatremia could improve outcomes should be evaluated in future studies. Strengths And Limitations There were also several limitations of this study. First, this was a single-center retrospective analysis, and we could only establish an association rather than a causal relationship. In addition, different results could be reached when using patient records from other centers. Therefore, subject selection bias cannot be ignored. Second, we only analyzed sodium levels at the time of AKI diagnosis, and these levels could change over time (e.g., initiating electrolyte therapy). Third, although we attempted to account for a number of potential confounders in the multivariable analyses, it is plausible that other unidentified variables may have influenced the results. Finally, we used all-cause mortality rather than cause-specific mortality, which was also a major limitation. Conclusion Sodium levels outside the interval of 130.0–141.9 mmol/L were associated with increased 90-day mortality and 1-year mortality risks in very elderly AKI patients. Abbreviations AKI = acute kidney injury; BMI = body mass index; COPD = chronic obstructive pulmonary disease; eGFR = estimated glomerular fitration rate; MAP = mean aortic pressure; 1 mmHg, 0.133 kPa. MV = mechanical ventilation; Scr = serum creatinine; BUN = blood urea nitrogen; BG = blood glucose; RRT = renal replacement therapy Declarations Acknowledgments This manuscript was edited for English language by American Journal Experts (AJE). Funding This study was funded by grants from the National Natural Science Foundation of China (No. 81871587), National Clinical Research Center for Geriatric Diseases of China (No. NCRCG-PLAGH-2017008) and WU JIEPING MEDICAL FOUNDATION (No. HRJJ20171039). Availability of data and material All data generated and/or analyzed during this study are included in this published article. Authors’ contributions QL participated in the conception and design of the study, did the statistical analyses, reviewed the literature, analyzed and interpreted the data, and drafted the manuscript. LP and ZM participated in the conception and design of the study, acquisition of data, analyzed and interpreted the data. HK was involved in design and in acquisition of data and helped to revise the manuscript critically for important content. FZ conceived of the study, participated in its design, and helped to revise manuscript. All authors read and approved the final manuscript. Ethical approval The study design was approved by the Clinical Ethics Committee of the Chinese PLA General Hospital. Informed consent For this type of study, formal consent is not required. Consent for publication The manuscript has been read and its submission approved by all coauthors. Competing interests The authors declare that they have no competing interests. References Lee SA, Cozzi M, Bush EL, Rabb H: Distant Organ Dysfunction in Acute Kidney Injury: A Review. American journal of kidney diseases : the official journal of the National Kidney Foundation 2018, 72(6):846-856. Yang L, Xing G, Wang L, Wu Y, Li S, Xu G, He Q, Chen J, Chen M, Liu X et al: Acute kidney injury in China: a cross-sectional survey. Lancet 2015, 386(10002):1465-1471. Anderson S, Eldadah B, Halter JB, Hazzard WR, Himmelfarb J, Horne FM, Kimmel PL, Molitoris BA, Murthy M, O'Hare AM et al: Acute kidney injury in older adults. Journal of the American Society of Nephrology : JASN 2011, 22(1):28-38. Hoste EAJ, Kellum JA, Selby NM, Zarbock A, Palevsky PM, Bagshaw SM, Goldstein SL, Cerda J, Chawla LS: Global epidemiology and outcomes of acute kidney injury. Nature reviews Nephrology 2018, 14(10):607-625. Moore PK, Hsu RK, Liu KD: Management of Acute Kidney Injury: Core Curriculum 2018. American journal of kidney diseases : the official journal of the National Kidney Foundation 2018, 72(1):136-148. Rewa O, Bagshaw SM: Acute kidney injury-epidemiology, outcomes and economics. Nature reviews Nephrology 2014, 10(4):193-207. Denic A, Glassock RJ, Rule AD: Structural and Functional Changes With the Aging Kidney. Adv Chronic Kidney Dis 2016, 23(1):19-28. Chao C-T, Tsai H-B, Lin Y-F, Ko W-J: Acute kidney injury in the elderly: Only the tip of the iceberg. Journal of Clinical Gerontology and Geriatrics 2014, 5(1):7-12. Kellum JA, Chawla LS: Acute kidney injury: still deadly 10 years later. American journal of respiratory and critical care medicine 2014, 189(9):1016-1017. Doyle JF, Forni LG: Acute kidney injury: short-term and long-term effects. Critical care 2016, 20(1):188. Sun L, Hou Y, Xiao Q, Du Y: Association of serum sodium and risk of all-cause mortality in patients with chronic kidney disease: A meta-analysis and sysematic review. Sci Rep 2017, 7(1):15949. Gao XP, Zheng CF, Liao MQ, He H, Liu YH, Jing CX, Zeng FF, Chen QS: Admission serum sodium and potassium levels predict survival among critically ill patients with acute kidney injury: a cohort study. BMC nephrology 2019, 20(1):311. Kidney Disease: Improving Global Outcomes (KDIGO) Acute Kidney Injury Work Group. KDIGO Clinical Practice Guideline for Acute Kidney Injury. Kidney inter, Suppl 2012: 2: 1–138. Levey AS, Stevens LA, Schmid CH, Zhang YL, Castro AF, 3rd, Feldman HI, Kusek JW, Eggers P, Van Lente F, Greene T et al: A new equation to estimate glomerular filtration rate. Ann Intern Med 2009, 150(9):604-612. Chao CT, Tsai HB, Wu CY, Lin YF, Hsu NC, Chen JS, Hung KY: The severity of initial acute kidney injury at admission of geriatric patients significantly correlates with subsequent in-hospital complications. Sci Rep 2015, 5(1):13925. Levy MM, Evans LE, Rhodes A: The Surviving Sepsis Campaign Bundle: 2018 update. Intensive care medicine 2018, 44(6):925-928. Mc Causland FR, Wright J, Waikar SS: Association of serum sodium with morbidity and mortality in hospitalized patients undergoing major orthopedic surgery. Journal of hospital medicine 2014, 9(5):297-302. Abdel-Kader K, Girard TD, Brummel NE, Saunders CT, Blume JD, Clark AJ, Vincz AJ, Ely EW, Jackson JC, Bell SP et al: Acute Kidney Injury and Subsequent Frailty Status in Survivors of Critical Illness: A Secondary Analysis. Critical care medicine 2018, 46(5):e380-e388. Baek SH, Lee SW, Kim SW, Ahn SY, Yu MY, Kim KI, Chin HJ, Na KY, Chae DW, Kim S: Frailty as a Predictor of Acute Kidney Injury in Hospitalized Elderly Patients: A Single Center, Retrospective Cohort Study. PloS one 2016, 11(6):e0156444. Muscedere J, Waters B, Varambally A, Bagshaw SM, Boyd JG, Maslove D, Sibley S, Rockwood K: The impact of frailty on intensive care unit outcomes: a systematic review and meta-analysis. Intensive care medicine 2017, 43(8):1105-1122. Christoffer, Polcwiartek, Steen, M?ller, Hansen, Kristian, Kragholm, Maria, Lukács, Krogager: Prognostic role of serum sodium levels across different serum potassium levels in heart failure patients: A Danish register-based cohort study. Funk GC, Lindner G, Druml W, Metnitz B, Schwarz C, Bauer P, Metnitz PGH: Incidence and prognosis of dysnatremias present on ICU admission. 36(2):304-311. Taffet G, Shah M, Workeneh B: Hypernatremia in the geriatric population. Clinical interventions in aging 2014:1987. Turgutalp K, Ozhan O, Gok Oguz E, Yilmaz A, Horoz M, Helvaci I, Kiykim A: Community-acquired hypernatremia in elderly and very elderly patients admitted to the hospital: clinical characteristics and outcomes. Medical science monitor : international medical journal of experimental and clinical research 2012, 18(12):CR729-734. Darmon M, Timsit J-F, Francais A, Nguile-Makao M, Adrie C, Cohen Y, Garrouste-Orgeas M, Goldgran-Toledano D, Dumenil A-S, Jamali S et al: Association between hypernatraemia acquired in the ICU and mortality: a cohort study. Nephrology Dialysis Transplantation 2010, 25(8):2510-2515. Hoorn EJ, Betjes MG, Weigel J, Zietse R: Hypernatraemia in critically ill patients: too little water and too much salt. Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association 2008, 23(5):1562-1568. Gregor, Lindner, and, Georg-Christian, Funk, and, Christoph, Schwarz, and, Nikolaus: Hypernatremia in the Critically Ill Is an Independent Risk Factor for Mortality. Funk GC, Lindner G, Druml W, Metnitz B, Schwarz C, Bauer P, Metnitz PG: Incidence and prognosis of dysnatremias present on ICU admission. Intensive care medicine 2010, 36(2):304-311. Wald R, Jaber BL, Price LL, Upadhyay A, Madias NE: Impact of hospital-associated hyponatremia on selected outcomes. 2010, 170(3):294. Waikar SS, Mount DB, Curhan GC: Mortality after hospitalization with mild, moderate, and severe hyponatremia. Am J Med 2009, 122(9):857-865. Stelfox HT, Ahmed SB, Zygun D, Khandwala F, Laupland K: Characterization of intensive care unit acquired hyponatremia and hypernatremia following cardiac surgery. Canadian journal of anaesthesia = Journal canadien d'anesthesie 2010, 57(7):650-658. Stelfox HT, Ahmed SB, Khandwala F, Zygun D, Shahpori R, Laupland K: The epidemiology of intensive care unit-acquired hyponatraemia and hypernatraemia in medical-surgical intensive care units. Critical care 2008, 12(6):R162. Peres LAB, Wandeur V, Matsuo T: Predictors of acute kidney injury and mortality in an Intensive Care Unit. 2015. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-16898","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research","associatedPublications":[],"authors":[{"id":399308,"identity":"9e693fdf-ac8f-4088-83f2-f2dcc06acbd9","order_by":1,"name":"Qinglin Li","email":"","orcid":"","institution":"Chinese PLA General Hospital","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Qinglin","middleName":"","lastName":"Li","suffix":""},{"id":399309,"identity":"d197f4d4-7286-41d7-8cf5-89632cbb4027","order_by":2,"name":"Liang Pan","email":"","orcid":"","institution":"Chinese PLA General Hospital","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Liang","middleName":"","lastName":"Pan","suffix":""},{"id":399310,"identity":"1c2343ea-a6ea-427d-a92c-5ce62809fac6","order_by":3,"name":"Zhi Mao","email":"","orcid":"","institution":"Chinese PLA General Hospital","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Zhi","middleName":"","lastName":"Mao","suffix":""},{"id":399311,"identity":"8b7de68d-fb78-49ef-9484-2eb9ddf3e1e5","order_by":4,"name":"Hongjun Kang","email":"","orcid":"","institution":"Chinese PLA General Hospital","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Hongjun","middleName":"","lastName":"Kang","suffix":""},{"id":399312,"identity":"601b214a-f90c-43a1-bd31-0b96c02e5b35","order_by":5,"name":"Feihu Zhou","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA5ElEQVRIie3PsYrCQBCA4REh2wym3SDEVxhYOK4Q7lWyCFsFEXyBiBAbH+CKewgfYcNwd41gm8JGBCuLlBYBTRArJdHOYv9mmvkYBsDlesNE0kmrYQH8WWILGoatBO2NSM6y74lRTxDwrgTMiLFg3U7EPN1juQ3JromH1I1A8O+qkWC2UIgHRbwkjskbAxqTN5EvqdM+Star+kpMOAWJH40EB7uKUE1i4k+SOmklslORqCYmYiB6gqBOgx/LKsjZZkuKlNf2C4r/gzyWHPY2s3lxKs+hL/ivkdznvbbucrlcrkddAEoqUQ56hng1AAAAAElFTkSuQmCC","orcid":"https://orcid.org/0000-0001-6154-013X","institution":"Chinese PLA General Hospital","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"Feihu","middleName":"","lastName":"Zhou","suffix":""}],"badges":[],"createdAt":"2020-03-07 14:39:54","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-16898/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-16898/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":636595,"identity":"aa653663-0633-4aa6-9dfa-425d3bdca68e","added_by":"auto","created_at":"2020-03-12 14:46:00","extension":"tif","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":25058,"visible":true,"origin":"","legend":"Kaplan–Meier plot of cumulative rates of 90-day mortality stratified by serum sodium levels (log-rank test: P \u003c 0.001)","description":"","filename":"Fig.1.tif","url":"https://assets-eu.researchsquare.com/files/rs-16898/v1/Fig. 1.tif"},{"id":636596,"identity":"08fe338b-a145-4882-a532-e7aa55138805","added_by":"auto","created_at":"2020-03-12 14:46:01","extension":"tif","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":29565,"visible":true,"origin":"","legend":"Kaplan–Meier plot of cumulative rates of 1-year mortality stratified by serum sodium levels (log-rank test: P \u003c 0.001)","description":"","filename":"Fig.2.tif","url":"https://assets-eu.researchsquare.com/files/rs-16898/v1/Fig. 2.tif"},{"id":13493121,"identity":"aa33129d-e2e6-40c6-8044-29bcd449ca0a","added_by":"auto","created_at":"2021-09-16 22:34:21","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":428180,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-16898/v1/df1f8c5f-baf0-4bc1-89ef-7248b4c0d297.pdf"}],"financialInterests":"","formattedTitle":"Associations of serum sodium levels with mortality in very elderly acute kidney injury patients","fulltext":[{"header":"Background","content":" \u003cp\u003eAcute kidney injury (AKI) is a common clinical acute critical illness that is frequently encountered in the elderly population.\u003csup\u003e[\u003cspan additionalcitationids=\"CR2\" citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]\u003c/sup\u003e The disorder is generally characterized by an abrupt deterioration in renal function (RF) that disrupts metabolic, electrolyte and fluid homeostasis over a period of hours to days.\u003csup\u003e[\u003cspan additionalcitationids=\"CR5\" citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]\u003c/sup\u003e Aging kidneys undergoing structural and functional changes that decrease autoregulatory capacity, systemic vasculature, and the immunological system render the elderly population highly susceptible to AKI.\u003csup\u003e[\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]\u003c/sup\u003e Previous studies of AKI in the elderly population mostly examined all-cause mortality, renal prognosis, or cardiovascular events.\u003csup\u003e[\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]\u003c/sup\u003e However, little work has been done on investigating electrolyte imbalances in very elderly AKI patients, such as dysnatremia and its association with mortality.\u003csup\u003e[\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eThe kidneys play a central role in sodium homeostasis, and their functional decline leads to electrolyte disorders.\u003csup\u003e[\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]\u003c/sup\u003e Recently, Gao reported that compared with the reference group (136.0\u0026ndash;144.9\u0026nbsp;mmol/L), AKI patients at the time of hospital admission with hyponatremia (\u0026lt;\u0026thinsp;136.0\u0026nbsp;mmol/L) or hypernatremia (\u0026ge;\u0026thinsp;145.0\u0026nbsp;mmol/L) had higher 90-day mortality rates.\u003csup\u003e[\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]\u003c/sup\u003e However, the independent or synergistic prognostic effects of abnormal serum sodium levels remain less well studied among very elderly AKI patients. In addition, the normal ranges of serum sodium levels that are applicable to such patients are still unknown.\u003c/p\u003e \u003cp\u003eTherefore, identifying the clinically significant normal ranges of serum sodium is an important issue for clinicians when making decisions regarding very elderly AKI patients with dysnatremia.\u003c/p\u003e "},{"header":"Materials And Methods","content":" \u003cp\u003eThis was a retrospective observational study conducted at the Chinese PLA General Hospital National Clinical Research Center for Geriatric Diseases (Beijing, China). All patients aged\u0026thinsp;\u0026ge;\u0026thinsp;75\u0026nbsp;years with normal renal function who were admitted between January 2007 and December 2018 were enrolled. The study design was approved by the Clinical Ethics Committee of the Chinese PLA General Hospital. All admissions were screened and evaluated for AKI and categorized according to the Kidney Disease: Improving Global Outcomes (KDIGO) criteria.\u003c/p\u003e \u003cp\u003eDemographic and basic data were obtained from the medical records. Serum sodium levels at the time of AKI diagnosis were recorded. Other laboratory data of interest included baseline serum creatinine (Scr) level, the Scr level at the time of AKI diagnosis, and the levels of blood urea nitrogen (BUN), uric acid, blood glucose (BG), electrolytes (K, Ca, P, and Mg), C-reactive protein (CRP), albumin, prealbumin, and hemoglobin.\u003c/p\u003e \u003cp\u003eThe exclusion criteria were as follows: patients who had been previously diagnosed with chronic kidney disease (CKD), a hospital stay\u0026thinsp;\u0026lt;\u0026thinsp;48\u0026nbsp;h, patients with no Scr data or only one Scr test, patients with insufficient medical records, and patients who died within 48\u0026nbsp;h of admission.\u003c/p\u003e \u003ch2\u003e Definitions\u003c/h2\u003e \u003cp\u003eThe 2012 KDIGO-defined Scr criteria were used to identify and classify AKI.\u003csup\u003e[\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]\u003c/sup\u003e The CKD Epidemiology Collaboration method was used to calculate the baseline estimated glomerular filtration rate (eGFR).\u003csup\u003e[\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]\u003c/sup\u003e The baseline Scr level was the most recent measure taken in the 1\u0026ndash;3 months before admission for AKI.\u003csup\u003e[\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]\u003c/sup\u003e Sepsis was defined according to the Surviving Sepsis Campaign Bundle: 2018 update.\u003csup\u003e[\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eThe normal sodium reference range (135.0\u0026ndash;145.0\u0026nbsp;mmol/L) was divided into three intervals. Furthermore, five intervals outside the normal sodium reference range were defined: one interval contained patients with a serum sodium level below 130.0\u0026nbsp;mmol/L, one contained those with a serum sodium level from 130.0\u0026nbsp;mmol/L to 134.9\u0026nbsp;mmol/L, one contained those with a serum sodium level from 145.0\u0026nbsp;mmol/L to 147.9\u0026nbsp;mmol/L, one contained those with a serum sodium level from 148.0\u0026nbsp;mmol/L to 151.9\u0026nbsp;mmol/L and last, one interval contained patients with a serum sodium above 152.0\u0026nbsp;mmol/L. Thus, this study contains eight sodium intervals, where the reference interval was defined as a sodium level from 135.0 to 137.9\u0026nbsp;mmol/L based on the analysis, which confirmed that the lowest mortality risk was found in this range (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cdiv class=\"SimplePara\"\u003eDemographic data stratification according to serum sodium levels\u003c/div\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"11\"\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eCharacteristic\u003c/div\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eAKI patients\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003en\u0026thinsp;=\u0026thinsp;744\u003c/div\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e\u0026lt;\u0026thinsp;130.0\u0026nbsp;mmol/L\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003en\u0026thinsp;=\u0026thinsp;36\u003c/div\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e130.0\u0026ndash;134.9\u0026nbsp;mmol/L\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003en\u0026thinsp;=\u0026thinsp;115\u003c/div\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e135.0\u0026ndash;137.9\u0026nbsp;mmol/L\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003en\u0026thinsp;=\u0026thinsp;102\u003c/div\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e138.0\u0026ndash;141.9\u0026nbsp;mmol/L\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003en\u0026thinsp;=\u0026thinsp;164\u003c/div\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e142.0\u0026ndash;144.9\u0026nbsp;mmol/L\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003en\u0026thinsp;=\u0026thinsp;88\u003c/div\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e145.0\u0026ndash;147.9\u0026nbsp;mmol/L\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003en\u0026thinsp;=\u0026thinsp;70\u003c/div\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e148.0\u0026ndash;151.9\u0026nbsp;mmol/L\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003en\u0026thinsp;=\u0026thinsp;72\u003c/div\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003e\u0026ge;\u0026thinsp;152.0\u0026nbsp;mmol/L\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003en\u0026thinsp;=\u0026thinsp;97\u003c/div\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003e\u003cspan type=\"Italic\" class=\"Italic\" name=\"Emphasis\"\u003eP-\u003c/span\u003evalue\u003c/div\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eAge (years)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e88 (84\u0026ndash;91)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e87 (82\u0026ndash;94)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e87 (84\u0026ndash;91)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e87 (82\u0026ndash;91)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e87 (83\u0026ndash;90)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e87 (84\u0026ndash;90)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e90 (86\u0026ndash;92)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e89 (85\u0026ndash;92)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003e89 (85\u0026ndash;92)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.003\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eMale sexr\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e701 (94.2)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e30 (83.3)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e108 (93.9)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e98 (96.1)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e150 (91.5)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e86 (97.7)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e67 (95.7)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e70 (97.2)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003e92 (94.8)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.085\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eBMI (kg/m\u003csup\u003e2\u003c/sup\u003e)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e23.0\u0026thinsp;\u0026plusmn;\u0026thinsp;3.1\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e23.2\u0026thinsp;\u0026plusmn;\u0026thinsp;2.7\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e23.1\u0026thinsp;\u0026plusmn;\u0026thinsp;3.2\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e23.5\u0026thinsp;\u0026plusmn;\u0026thinsp;3.0\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e23.2\u0026thinsp;\u0026plusmn;\u0026thinsp;3.4\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e22.9\u0026thinsp;\u0026plusmn;\u0026thinsp;3.1\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e22.6\u0026thinsp;\u0026plusmn;\u0026thinsp;3.3\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e22.5\u0026thinsp;\u0026plusmn;\u0026thinsp;2.7\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003e22.6\u0026thinsp;\u0026plusmn;\u0026thinsp;2.9\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.256\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eComorbidity\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eCoronary disease\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e565 (75.9)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e24 (66.7)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e94 (81.7)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e85 (83.3)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e120 (73.2)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e60 (68.2)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e54 (77.1)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e58 (80.6)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003e70 (72.2)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.097\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eHypertension\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e546 (73.4)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e28 (77.8)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e83 (72.2)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e80 (78.4)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e121 (73.8)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e67 (76.1)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e53 (75.7)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e52 (72.2)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003e62 (63.9)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.448\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eCOPD\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e511 (68.7)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e20 (55.6)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e79 (68.7)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e69 (67.6)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e111 (67.7)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e59 (67.0)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e52 (74.3)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e53 (73.6)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003e68 (70.1)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.654\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eDiabetes\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e283 (38.0)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e10 (27.8)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e44 (38.3)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e44 (43.1)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e64 (39.0)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e35 (39.8)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e19 (27.1)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e25 (34.7)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003e42 (43.3)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.340\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eBaseline Scr (\u0026micro;mol/L)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e72.0 (60.0\u0026ndash;82.0)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e70.0 (64.0\u0026ndash;80.0)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e72.0 (58.0\u0026ndash;81.0)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e78.0 (62.0\u0026ndash;86.0)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e76.0 (62.0\u0026ndash;84.0)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e72.0 (63.0\u0026ndash;83.0)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e69.0 (57.0\u0026ndash;80.0)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e67.0 (56.0\u0026ndash;80.0)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003e66.0 (56.0\u0026ndash;78.0)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003e\u0026lt;\u0026thinsp;0.001\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eBaseline eGFR (mL/min/1.73\u0026nbsp;m\u003csup\u003e2\u003c/sup\u003e)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e78.7 (72.2\u0026ndash;85.4)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e78.1 (72.8\u0026ndash;85.7)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e79.0 (73.8\u0026ndash;84.8)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e76.8 (69.5\u0026ndash;83.2)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e77.7 (70.2\u0026ndash;84.8)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e78.6 (72.2\u0026ndash;85.7)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e81.1 (72.0\u0026ndash;85.7)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e80.4 (74.8\u0026ndash;86.8)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003e80.7 (75.7\u0026ndash;87.1)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.056\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eEtiology of AKI\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eSepsis\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e312 (41.9)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e19 (52.8)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e34 (29.6)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e32 (31.4)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e59 (36.0)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e35 (39.8)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e38 (54.3)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e39 (54.2)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003e56 (57.7)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003e\u0026lt;\u0026thinsp;0.001\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eHypovolemia\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e159 (21.4)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e6 (16.7)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e25 (21.7)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e30 (29.4)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e30 (18.3)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e19 (21.6)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e16 (22.9)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e17 (23.6)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003e16 (16.5)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.427\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eCardiovascular events\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e111 (14.9)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e7 (19.4)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e25 (21.7)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e15 (14.7)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e23 (14.0)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e14 (15.9)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e10 (14.3)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e8 (11.1)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003e9 (9.3)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.311\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eNephrotoxicity\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e89 (12.0)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e3 (8.3)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e14 (12.2)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e10 (9.8)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e26 (15.9)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e13 (14.8)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e5 (7.1)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e6 (8.3)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003e12 (12.4)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.477\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eSurgery\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e49 (6.6)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e1 (2.8)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e8 (7.0)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e13 (12.7)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e21 (12.8)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e4 (4.5)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e1 (1.4)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e1 (1.4)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003e0\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003e\u0026lt;\u0026thinsp;0.001\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eOthers\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e24 (3.2)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e0\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e9 (7.8)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e2 (2.0)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e5 (3.0)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e3 (3.4)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e0\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e1 (1.4)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003e4 (4.1)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.044\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eClinical conditions\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eMAP (mmHg)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e78\u0026thinsp;\u0026plusmn;\u0026thinsp;14\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e80\u0026thinsp;\u0026plusmn;\u0026thinsp;14\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e76\u0026thinsp;\u0026plusmn;\u0026thinsp;13\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e79\u0026thinsp;\u0026plusmn;\u0026thinsp;15\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e81\u0026thinsp;\u0026plusmn;\u0026thinsp;12\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e79\u0026thinsp;\u0026plusmn;\u0026thinsp;15\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e75\u0026thinsp;\u0026plusmn;\u0026thinsp;14\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e75\u0026thinsp;\u0026plusmn;\u0026thinsp;15\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003e76\u0026thinsp;\u0026plusmn;\u0026thinsp;16\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.012\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eOliguria\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e46 (6.2)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e5 (13.9)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e11 (9.6)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e2 (2.0)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e9 (5.5)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e4 (4.5)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e4 (5.7)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e6 (8.3)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003e5 (5.2)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.174\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eMV\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e298 (40.1)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e7 (19.4)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e44 (38.3)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e22 (21.6)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e37 (22.6)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e34 (38.6)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e42 (60.0)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e50 (69.4)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003e62 (63.9)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003e\u0026lt;\u0026thinsp;0.001\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003ePharmacotherapy\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eACEIs/ARBs\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e414 (55.6)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e19 (52.8)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e60 (52.2)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e66 (64.7)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e98 (59.8)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e49 (55.7)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e40 (57.1)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e37 (51.4)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003e45 (46.4)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.242\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eBeta-blockers\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e336 (45.2)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e17 (47.2)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e51 (44.3)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e48 (47.1)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e81 (49.4)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e41 (46.6)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e30 (42.9)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e30 (41.7)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003e38 (39.2)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.845\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eCalcium channel blockers\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e306 (41.1)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e16 (44.4)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e45 (39.1)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e50 (49.0)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e69 (42.1)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e40 (45.5)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e27 (38.6)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e28 (38.9)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003e31 (32.0)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.386\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eDiuretics\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e602 (80.9)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e29 (80.6)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e88 (76.5)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e85 (83.3)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e130 (79.3)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e74 (84.1)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e59 (84.3)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e61 (84.7)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003e76 (78.4)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.745\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eLaboratory parameters\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eScr (\u0026micro;mol/L)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e128.4. (115.0\u0026ndash;145.0)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e131.5 (116.3\u0026ndash;145.0)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e125.0 (109.0\u0026ndash;144.0)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e128.5 (115.0\u0026ndash;144.3)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e126.6 (115.3\u0026ndash;142.2)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e124.7.0 (115.0\u0026ndash;150.0)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e131.6 (113.8\u0026ndash;145.1)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e136.0 (120.9\u0026ndash;156.9)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003e135.5 (116.6\u0026ndash;149.3)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.036\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003ePeak Scr (\u0026micro;mol/L)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e144.0 (124.0\u0026ndash;206.4)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e140.1 (123.3\u0026ndash;278.5)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e136.1 (116.9\u0026ndash;211.7)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e138.0 (122.0\u0026ndash;180.1)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e137.0 (123.1\u0026ndash;166.0)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e148.5 (122.8\u0026ndash;207.6)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e171.0 (126.0\u0026ndash;237.6)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e172.5 (131.3\u0026ndash;267.0)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003e170.0 (139.1\u0026ndash;234.6)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003e\u0026lt;\u0026thinsp;0.001\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eBUN (mmol/L)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e12.7 (8.9\u0026ndash;20.7)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e11.0 (9.4\u0026ndash;17.0)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e11.4 (8.8\u0026ndash;14.7)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e9.6 (7.4\u0026ndash;14.9)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e10.3 (7.5\u0026ndash;13.8)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e12.0 (8.4\u0026ndash;17.6)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e17.1 (9.4\u0026ndash;25.5)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e21.1 (15.1\u0026ndash;28.4)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003e21.6 (16.6\u0026ndash;36.8)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003e\u0026lt;\u0026thinsp;0.001\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003ePeak BUN (mmol/L)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e17.5 (10.7\u0026ndash;32.9)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e20.0 (10.0\u0026ndash;36.6)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e14.7 (10.0\u0026ndash;26.7)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e12.8 (9.0\u0026ndash;20.5)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e11.4 (8.8\u0026ndash;22.2)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e15.9 (9.6\u0026ndash;27.3)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e23.8 (13.1\u0026ndash;34.2)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e30.3 (21.4\u0026ndash;41.6)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003e32.5 (21.3\u0026ndash;42.9)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003e\u0026lt;\u0026thinsp;0.001\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eUric acid (mmol/L)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e366.5 (291.3\u0026ndash;468.3)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e355.5 (255.4\u0026ndash;421.3)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e356.4 (283.6\u0026ndash;485.0)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e369.1 (287.9\u0026ndash;448.2)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e350.5 (281.6\u0026ndash;428.5)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e362.9 (267.4\u0026ndash;468.9)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e404.0 (316.8\u0026ndash;538.8)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e363.7 (308.3\u0026ndash;509.3)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003e417.0 (336.9\u0026ndash;547.0)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.111\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eBG (mmol/L)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e7.4 (5.8\u0026ndash;10.3)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e8.3 (6.2\u0026ndash;10.3)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e7.6 (5.8\u0026ndash;11.2)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e7.7 (5.9\u0026ndash;9.9)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e6.9 (5.3\u0026ndash;9.4)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e6.4 (5.2\u0026ndash;8.6)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e7.6 (6.1\u0026ndash;9.4)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e7.9 (6.4\u0026ndash;10.1)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003e9.3 (7.0\u0026ndash;12.7)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003e\u0026lt;\u0026thinsp;0.001\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eK (mmol/L)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e4.2 (3.8\u0026ndash;4.7)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e4.5 (4.0\u0026ndash;4.9)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e4.3 (3.9\u0026ndash;4.9)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e4.1 (3.8\u0026ndash;4.5)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e4.1 (3.8\u0026ndash;4.6)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e4.1 (3.8\u0026ndash;4.7)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e4.0 (3.7\u0026ndash;4.8)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e4.3 (3.9\u0026ndash;4.9)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003e4.1 (3.7\u0026ndash;4.4)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.165\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eNa (mmol/L)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e140.0 (136.0\u0026ndash;147.0)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e127.0 (124.0\u0026ndash;128.0)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e132.0 (131.0\u0026ndash;134.0)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e136.0 (136.0\u0026ndash;137.0)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e139.0 (138.0\u0026ndash;140.0)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e143.0 (142.0\u0026ndash;144.0)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e146.0 (145.0\u0026ndash;147.0)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e149.0 (148.0\u0026ndash;150.0)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003e157.0 (154.0\u0026ndash;161.0)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003e\u0026lt;\u0026thinsp;0.001\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eCa (mmol/L)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e2.2 (2.1\u0026ndash;2.4)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e2.2 (2.0\u0026ndash;2.3)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e2.2 (2.1\u0026ndash;2.4)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e2.2 (2.1\u0026ndash;2.3)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e2.2 (2.1\u0026ndash;2.3)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e2.2 (2.1\u0026ndash;2.3)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e2.2 (2.0\u0026ndash;2.4)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e2.2 (2.0\u0026ndash;2.3)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003e2.3 (2.1\u0026ndash;2.5)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.072\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eP (mmol/L)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e1.2 (0.9\u0026ndash;1.4)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e1.1 (1.0\u0026ndash;1.4)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e1.1 (0.9\u0026ndash;1.4)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e1.1 (0.9\u0026ndash;1.4)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e1.2 (1.0\u0026ndash;1.5)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e1.2 (1.1\u0026ndash;1.4)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e1.2 (1.0\u0026ndash;1.5)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e1.2 (0.9\u0026ndash;1.4)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003e1.2 (1.0\u0026ndash;1.5)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.062\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eMg (mmol/L)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.9 (0.8\u0026ndash;1.0)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.8 (0.7\u0026ndash;0.9)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.9 (0.8\u0026ndash;1.0)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.9 (0.8\u0026ndash;1.0)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.9 (0.8\u0026ndash;1.0)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.9 (0.8\u0026ndash;1.0)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.9 (0.8\u0026ndash;1.0)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e1.0 (0.8\u0026ndash;1.1)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003e1.0 (0.9\u0026ndash;1.1)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003e\u0026lt;\u0026thinsp;0.001\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eCRP (mmol/L)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e4.2 (1.9\u0026ndash;9.6)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e4.7 (1.9\u0026ndash;11.0)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e4.9 (2.3\u0026ndash;10.0)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e3.3 (1.6\u0026ndash;9.5)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e3.2 (1.6\u0026ndash;7.3)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e3.6 (1.6\u0026ndash;8.4)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e5.6 (2.4\u0026ndash;13.2)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e5.6 (2.1\u0026ndash;11.0)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003e4.4 (2.3\u0026ndash;9.9)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.112\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eAlbumin (g/L)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e34.2\u0026thinsp;\u0026plusmn;\u0026thinsp;5.6\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e33.4\u0026thinsp;\u0026plusmn;\u0026thinsp;7.3\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e35.1\u0026thinsp;\u0026plusmn;\u0026thinsp;5.8\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e35.3\u0026thinsp;\u0026plusmn;\u0026thinsp;5.5\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e35.5\u0026thinsp;\u0026plusmn;\u0026thinsp;4.9\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e34.4\u0026thinsp;\u0026plusmn;\u0026thinsp;5.2\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e33.8\u0026thinsp;\u0026plusmn;\u0026thinsp;5.5\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e31.8\u0026thinsp;\u0026plusmn;\u0026thinsp;5.7\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003e32.2\u0026thinsp;\u0026plusmn;\u0026thinsp;4.9\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003e\u0026lt;\u0026thinsp;0.001\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003ePrealbumin (g/L)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e176.0 (134.0\u0026ndash;229.0)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e160.0 (115.0\u0026ndash;219.0)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e171 (145\u0026ndash;208)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e198 (148\u0026ndash;248)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e205 (155\u0026ndash;259)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e170 (134\u0026ndash;230)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e163 (125\u0026ndash;226)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e159 (122\u0026ndash;226)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003e156 (134\u0026ndash;205)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.003\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eHemoglobin (g/L)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e112\u0026thinsp;\u0026plusmn;\u0026thinsp;22\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e115\u0026thinsp;\u0026plusmn;\u0026thinsp;20\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e113\u0026thinsp;\u0026plusmn;\u0026thinsp;21\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e117\u0026thinsp;\u0026plusmn;\u0026thinsp;21\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e115\u0026thinsp;\u0026plusmn;\u0026thinsp;23\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e112\u0026thinsp;\u0026plusmn;\u0026thinsp;21\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e106\u0026thinsp;\u0026plusmn;\u0026thinsp;21\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e105\u0026thinsp;\u0026plusmn;\u0026thinsp;24\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003e108\u0026thinsp;\u0026plusmn;\u0026thinsp;23\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003e\u0026lt;\u0026thinsp;0.001\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eAKI Stage\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003e\u0026lt;\u0026thinsp;0.001\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003e1\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e323 (43.4)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e15 (41.7)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e57 (49.6)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e58 (56.9)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e95 (57.9)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e42 (47.7)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e22 (31.4)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e14 (19.4)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003e20 (20.6)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003e2\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e190 (25.5)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e9 (25.0)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e27 (23.5)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e22 (21.6)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e38 (23.2)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e18 (20.5)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e18 (25.7)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e25 (34.7)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003e33 (34.0)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003e3\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e231 (31.0)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e12 (33.3)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e31 (27.0)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e22 (21.6)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e31 (18.9)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e28 (31.8)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e30 (42.9)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e33 (45.8)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003e44 (45.4)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eOutcomes\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eRRT\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e4 (0.5)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e1 (2.8)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e2 (1.7)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e1 (1.0)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e0\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e0\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e0\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e0\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003e0\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.236\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003e90-day mortality\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e260 (34.9)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e13 (36.1)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e32 (27.8)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e20 (19.6)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e40 (24.4)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e27 (30.7)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e34 (48.6)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e38 (52.8)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003e56 (57.7)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003e\u0026lt;\u0026thinsp;0.001\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003e1-year mortality\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e383 (51.8)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e21 (58.3)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e54 (47.8) \u003csup\u003e*\u003c/sup\u003e\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e34 (33.7) \u003csup\u003e#\u003c/sup\u003e\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e63 (38.9) \u003csup\u003e*\u003c/sup\u003e\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e40 (45.5)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e45 (64.3)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e50 (69.4)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003e76 (78.4)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003e\u0026lt;\u0026thinsp;0.001\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003ch2\u003e Outcomes\u003c/h2\u003e \u003cp\u003eThe outcome of the study was all-cause mortality within 90\u0026nbsp;days and within 1\u0026nbsp;year after AKI diagnosis.\u003c/p\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eStatistical analysis\u003c/h2\u003e \u003cp\u003eContinuous variables are presented as the mean\u0026thinsp;\u0026plusmn;\u0026thinsp;standard deviation for parametric variables or as the median with interquartile range (with 25th and 75th percentiles) for nonparametric variables. Categorical variables are presented as numbers (n) or percentages (%). Group comparisons were conducted using ANOVA or the Kruskal\u0026ndash;Wallis H test for continuous variables and Pearson\u0026rsquo;s chi-square or Fisher\u0026rsquo;s exact test for categorical variables. Prognostic survival factors were identified using the Cox proportional hazards regression model. Survival probability was estimated using the Kaplan\u0026ndash;Meier method for the eight potassium intervals, and curves were compared among groups using the log-rank test. A \u003cspan type=\"Italic\" class=\"Italic\" name=\"Emphasis\"\u003eP\u003c/span\u003e-value\u0026thinsp;\u0026lt;\u0026thinsp;0.05 was considered significant. Statistical analyses were performed using SPSS version 21.0 for Windows software (SPSS Inc., Chicago, IL, USA).\u003c/p\u003e \u003c/div\u003e "},{"header":"Results","content":" \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003eStudy population\u003c/h2\u003e \u003cp\u003eIn the period 2007\u0026ndash;2018, a total of 3861 very elderly patients (aged\u0026thinsp;\u0026ge;\u0026thinsp;75\u0026nbsp;years) were hospitalized at the National Clinical Research Center for Geriatric Diseases, 760 of whom developed AKI during hospitalization. Of these patients, 13 were excluded because of a length of hospital stay of less than 48 hours, 3 were excluded because of missing data that was required for this study, and 744 AKI patients were suitable for the final analysis. The median age of the 744 participants was 88 years, and the majority (701, 94.2%) were male. Among all patients, 260 (34.9%) died within 90\u0026nbsp;days. During the 1-year follow-up, 5 patients were lost, and 383 (51.8%) died.\u003c/p\u003e \u003c/div\u003e \u003ch2\u003e General Conditions And Clinical Characteristics According To Sodium Levels\u003c/h2\u003e \u003cp\u003eA summary of the baseline characteristics of the study population is provided in Table 1. The overall median serum sodium level when AKI was diagnosed was 140.0\u0026nbsp;mmol/L (136.0\u0026ndash;147.0\u0026nbsp;mmol/L). Thirty-six patients were in the low sodium group (\u0026lt;\u0026thinsp;130.0\u0026nbsp;mmol/L), 115 in the sodium group 130.0\u0026ndash;134.9\u0026nbsp;mmol/L, 102 in the sodium group 135.0\u0026ndash;137.9\u0026nbsp;mmol/L, 164 in the sodium group 138.0\u0026ndash;141.9\u0026nbsp;mmol/L, 88 in the sodium group 142.0\u0026ndash;144.9\u0026nbsp;mmol/L, 70 in the sodium group 145.0\u0026ndash;147.9\u0026nbsp;mmol/L, 72 in the sodium group 148.0\u0026ndash;151.9\u0026nbsp;mmol/L, and 97 in the sodium group\u0026thinsp;\u0026ge;\u0026thinsp;152.0\u0026nbsp;mmol/L. Age, baseline Scr, sepsis, surgery, mean aortic pressure, need for mechanical ventilation, Scr, peak Scr, BUN, peak BUN, BG, Mg, prealbumin, albumin, hemoglobin, and AKI stage differed significantly among the 8 groups at the time of AKI diagnosis. Significant interactions were also observed between serum sodium levels and both 90-day mortality (\u003cspan type=\"Italic\" class=\"Italic\" name=\"Emphasis\"\u003eP\u003c/span\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001) and 1-year mortality (\u003cspan type=\"Italic\" class=\"Italic\" name=\"Emphasis\"\u003eP\u003c/span\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001). The 90-day mortality rates in the eight sodium interval groups from the lowest (\u0026lt;\u0026thinsp;130.0\u0026nbsp;mmol/L) to the highest (\u0026ge;\u0026thinsp;152.0\u0026nbsp;mmol/L) were 36.1, 27.8, 19.6, 24.4, 30.7, 48.6, 52.8, and 57.7%, respectively. The 1-year mortality rates in the eight strata were 58.3, 47.8, 33.7, 38.9, 45.5, 64.3, 69.4, and 78.4%, respectively.\u003c/p\u003e \u003ch2\u003eSurvival analysis \u003c/h2\u003e \u003cp\u003eOf the patients, 260 (34.9%) died during the 90-day follow-up. Survival curves for 90-day all-cause mortality across categories of serum sodium are presented in Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e. As shown in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e, among all the deaths from AKI, 5.0% of the patients had sodium levels\u0026thinsp;\u0026lt;\u0026thinsp;130.0\u0026nbsp;mmol/L, 12.3% had sodium levels from 130.0 to 134.9\u0026nbsp;mmol/L, 7.7% had sodium levels from 135.0 to 137.9\u0026nbsp;mmol/L, 15.4% had sodium levels from 138.0 to 141.9\u0026nbsp;mmol/L, 10.4% had sodium levels from 142.0 to 144.9\u0026nbsp;mmol/L, 13.1% had sodium levels from 145.0 to 147.9\u0026nbsp;mmol/L, 14.6% had sodium levels from 148.0 to 151.9\u0026nbsp;mmol/L, and 21.5% had sodium levels\u0026thinsp;\u0026ge;\u0026thinsp;152.0\u0026nbsp;mmol/L.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cdiv class=\"SimplePara\"\u003eAssociation of categories of serum sodium levels with 90-day and 1-year mortality\u003c/div\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"8\"\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cdiv class=\"SimplePara\"\u003eCharacteristic\u003c/div\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e90-day outcomes\u003c/div\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c8\" namest=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e1-year outcomes\u003c/div\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eNonsurvivors\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003e\u003cspan type=\"Italic\" class=\"Italic\" name=\"Emphasis\"\u003en\u003c/span\u003e\u0026thinsp;=\u0026thinsp;260 (34.9)\u003c/div\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003eSurvivors\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003e\u003cspan type=\"Italic\" class=\"Italic\" name=\"Emphasis\"\u003en\u003c/span\u003e\u0026thinsp;=\u0026thinsp;484 (65.1)\u003c/div\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e\u003cspan type=\"Italic\" class=\"Italic\" name=\"Emphasis\"\u003eP\u003c/span\u003e\u003c/div\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003eNonsurvivors\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003e\u003cspan type=\"Italic\" class=\"Italic\" name=\"Emphasis\"\u003en\u003c/span\u003e\u0026thinsp;=\u0026thinsp;383 (51.8)\u003c/div\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003eSurvivors\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003e\u003cspan type=\"Italic\" class=\"Italic\" name=\"Emphasis\"\u003en\u003c/span\u003e\u0026thinsp;=\u0026thinsp;356 (48.2)\u003c/div\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e\u003cspan type=\"Italic\" class=\"Italic\" name=\"Emphasis\"\u003eP\u003c/span\u003e\u003c/div\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eSodium levels (mmol/L)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e\u0026lt;\u0026thinsp;0.001\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e\u0026lt;\u0026thinsp;0.001\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003e\u0026lt;\u0026thinsp;130.0\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e13 (5.0)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e23 (4.8)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e21 (5.5)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e15 (4.2)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003e130.0\u0026ndash;134.9\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e32 (12.3)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e83 (17.1)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e54 (14.1)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e59 (16.6)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003e135.0\u0026ndash;137.9\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e20 (7.7)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e82 (16.9)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e34 (8.9)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e67 (18.8)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003e138.0\u0026ndash;141.9\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e40 (15.4)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e124 (25.6)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e63 (16.4)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e99 (27.8)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003e142.0\u0026ndash;144.9\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e27 (10.4)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e61 (12.6)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e40 (10.4)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e48 (13.5)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003e145.0\u0026ndash;147.9\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e34 (13.1)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e36 (7.4)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e45 (11.7)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e25 (7.0)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003e148.0\u0026ndash;151.9\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e38 (14.6)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e34 (7.0)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e50 (13.1)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e22 (6.2)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003e\u0026ge;\u0026thinsp;152.0\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e56 (21.5)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e41 (8.5)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e76 (19.8)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e21 (5.9)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cdiv class=\"SimplePara\"\u003eMultivariate Cox proportional hazard model analysis of risk factors for mortality\u003c/div\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"8\"\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cdiv class=\"SimplePara\"\u003eRisk factor\u003c/div\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e90-day mortality\u003c/div\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e1-year mortality\u003c/div\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eHR\u003c/div\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e95%CI\u003c/div\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e\u003cspan type=\"Italic\" class=\"Italic\" name=\"Emphasis\"\u003eP\u003c/span\u003e\u003c/div\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003eHR\u003c/div\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e95%CI\u003c/div\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e\u003cspan type=\"Italic\" class=\"Italic\" name=\"Emphasis\"\u003eP\u003c/span\u003e\u003c/div\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eMAP\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.960\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.951\u0026ndash;0.968\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e\u0026lt;\u0026thinsp;0.001\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.979\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.972\u0026ndash;0.986\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e\u0026lt;\u0026thinsp;0.001\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eAlbumin\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e\u0026ndash;\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e\u0026ndash;\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e\u0026ndash;\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.906\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.887\u0026ndash;0.924\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e\u0026lt;\u0026thinsp;0.001\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eSodium levels (mmol/L)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e\u0026lt;\u0026thinsp;0.001\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e\u0026lt;\u0026thinsp;0.001\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003e135.0\u0026ndash;137.9\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eReference\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003eReference\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e\u0026ndash;\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003eReference\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003eReference\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e\u0026ndash;\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003e\u0026lt; 130.0\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e2.247\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e1.117\u0026ndash;4.521\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.023\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e1.944\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e1.125\u0026ndash;3.360\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.017\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003e130.0\u0026ndash;134.9\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e1.442\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.825\u0026ndash;2.522\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.199\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e1.436\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.935\u0026ndash;2.207\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.099\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003e138.0\u0026ndash;141.9\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e1.438\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.840\u0026ndash;2.463\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.186\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e1.428\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.938\u0026ndash;2.173\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.097\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003e142.0\u0026ndash;144.9\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e1.964\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e1.100\u0026ndash;3.508\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.022\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e1.681\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e1.062\u0026ndash;2.660\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.027\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003e145.0\u0026ndash;147.9\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e2.942\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e1.693\u0026ndash;5.114\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e\u0026lt;\u0026thinsp;0.001\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e2.631\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e1.683\u0026ndash;4.112\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e\u0026lt;\u0026thinsp;0.001\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003e148.0\u0026ndash;151.9\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e3.455\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e2.009\u0026ndash;5.944\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e\u0026lt;\u0026thinsp;0.001\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e2.411\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e1.552\u0026ndash;3.744\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e\u0026lt;\u0026thinsp;0.001\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003e\u0026ge;\u0026thinsp;152.0\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e3.587\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e2.151\u0026ndash;5.983\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e\u0026lt;\u0026thinsp;0.001\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e3.037\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e2.021\u0026ndash;4.563\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e\u0026lt;\u0026thinsp;0.001\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eDuring the 1-year follow-up, 5 patients were lost, and 383 (51.8%) died. Survival curves for 1-year all-cause mortality across categories of serum sodium are presented in Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e. Among all the deaths from AKI, 5.5% of the patients had sodium levels\u0026thinsp;\u0026lt;\u0026thinsp;130.0\u0026nbsp;mmol/L, 14.1% had sodium levels from 130.0 to 134.9\u0026nbsp;mmol/L, 8.9% had sodium levels from 135.0 to 137.9\u0026nbsp;mmol/L, 16.4% had sodium levels from 138.0 to 141.9\u0026nbsp;mmol/L, 10.4% had sodium levels from 142.0 to 144.9\u0026nbsp;mmol/L, 11.7% had sodium levels from 145.0 to 147.9\u0026nbsp;mmol/L, 13.1% had sodium levels from 148.0 to 151.9\u0026nbsp;mmol/L, and 19.8% had sodium levels\u0026thinsp;\u0026ge;\u0026thinsp;152.0\u0026nbsp;mmol/L.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eIn the multivariable adjusted analysis, patients with sodium levels\u0026thinsp;\u0026lt;\u0026thinsp;130.0\u0026nbsp;mmol/L [hazard ratio (HR): 2.247; 95% confidence interval (CI): 1.117\u0026ndash;4.521; \u003cspan type=\"Italic\" class=\"Italic\" name=\"Emphasis\"\u003eP\u003c/span\u003e\u0026thinsp;=\u0026thinsp;0.023], from 142.0 to 144.9\u0026nbsp;mmol/L (HR: 1.964; 95% CI: 1.100\u0026ndash;3.508; \u003cspan type=\"Italic\" class=\"Italic\" name=\"Emphasis\"\u003eP\u003c/span\u003e\u0026thinsp;=\u0026thinsp;0.022), from 145.0 to 147.9\u0026nbsp;mmol/L (HR: 2.942; 95% CI: 1.693\u0026ndash;5.114; \u003cspan type=\"Italic\" class=\"Italic\" name=\"Emphasis\"\u003eP\u003c/span\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001), from 148.0 to 151.9\u0026nbsp;mmol/L (HR: 3.455; 95% CI: 2.009\u0026ndash;5.944; \u003cspan type=\"Italic\" class=\"Italic\" name=\"Emphasis\"\u003eP\u003c/span\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001), and \u0026ge;\u0026thinsp;152.0\u0026nbsp;mmol/L (HR: 3.587; 95% CI: 2.151\u0026ndash;5.983; \u003cspan type=\"Italic\" class=\"Italic\" name=\"Emphasis\"\u003eP\u003c/span\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001) had relatively higher 90-day mortality rates.\u003c/p\u003e \u003cp\u003eSignificant interactions were also observed between serum sodium levels and 1-year mortality: patients with sodium levels\u0026thinsp;\u0026lt;\u0026thinsp;130.0\u0026nbsp;mmol/L (HR: 1.944; 95% CI: 1.125\u0026ndash;3.360; \u003cspan type=\"Italic\" class=\"Italic\" name=\"Emphasis\"\u003eP\u003c/span\u003e\u0026thinsp;=\u0026thinsp;0.017), from 142.0 to 144.9\u0026nbsp;mmol/L (HR: 1.681; 95% CI: 1.062\u0026ndash;2.660; \u003cspan type=\"Italic\" class=\"Italic\" name=\"Emphasis\"\u003eP\u003c/span\u003e\u0026thinsp;=\u0026thinsp;0.027), from 145.0 to 147.9\u0026nbsp;mmol/L (HR: 2.631; 95% CI: 1.683\u0026ndash;4.112; \u003cspan type=\"Italic\" class=\"Italic\" name=\"Emphasis\"\u003eP\u003c/span\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001), from 148.0 to 151.9\u0026nbsp;mmol/L (HR: 2.411; 95% CI: 1.552\u0026ndash;3.744; \u003cspan type=\"Italic\" class=\"Italic\" name=\"Emphasis\"\u003eP\u003c/span\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001), and \u0026ge;\u0026thinsp;152.0\u0026nbsp;mmol/L (HR: 3.037; 95% CI: 2.021\u0026ndash;4.563; \u003cspan type=\"Italic\" class=\"Italic\" name=\"Emphasis\"\u003eP\u003c/span\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001) had relatively higher 1-year mortality rates.\u003c/p\u003e "},{"header":"Discussion","content":" \u003cp\u003eSodium is the main electrolyte responsible for serum osmolarity.\u003csup\u003e[\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]\u003c/sup\u003e Patients suffering from AKI have impaired sodium homeostasis. Dysnatremia is the most common electrolyte abnormality in clinical practice, as our study found (52.4%).\u003csup\u003e[\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]\u003c/sup\u003e No studies have independently or simultaneously investigated the prognostic role of such electrolytes among very elderly patients with AKI. This study analyzed the 90-day mortality and 1-year mortality risks in relation to different serum sodium intervals in very elderly AKI patients. It was not surprising that sodium levels outside the normal range (Na\u0026thinsp;\u0026lt;\u0026thinsp;130.0 and \u0026gt;\u0026thinsp;145.0\u0026nbsp;mmol/L) were associated with an increased mortality risk; it was unexpected that one normal sodium level (Na: 142.0\u0026ndash;144.9\u0026nbsp;mmol/L) was also associated with a significantly increased mortality risk in AKI patients.\u003c/p\u003e \u003cp\u003eIn the elderly population, the incidence of electrolyte imbalance is expected to be higher because of organ decline, decreased physiologic reserves, frailty, and the higher prevalence of disability and functional impairment.\u003csup\u003e[\u003cspan additionalcitationids=\"CR19\" citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]\u003c/sup\u003e Kidneys are responsible for maintaining water homeostasis, and AKI could magnify the effect of dysnatremia on the clinical consequences. Normal ranges of serum sodium levels within 135.0\u0026ndash;145.0\u0026nbsp;mmol/L used in clinical settings are determined mainly based on healthy subjects, and whether these values are applicable to elderly patients with complex comorbidities is still unknown.\u003csup\u003e[\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]\u003c/sup\u003e Through interfering with tubular functions, AKI disturbs the physiological regulation of electrolyte homeostasis, which could be more prominent in the elderly population. Previous studies have consistently reported that electrolyte imbalances, including dysnatremia and dyskalemia, are associated with worse in-hospital outcomes. Furthermore, the adverse impact of dysnatremia on clinical outcomes might be independent of the presence of initial AKI.\u003c/p\u003e \u003cp\u003eHypernatremia is characterized by a deficit of total body water relative to the total body sodium level and is defined as a serum sodium concentration exceeding 145\u0026nbsp;mmol/L.\u003csup\u003e[\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]\u003c/sup\u003e Hypernatremia in the geriatric population is a common disorder associated with significant mortality. Older people are predisposed to developing hypernatremia because of age-related physiologic changes such as decreased thirst drive, impaired urinary concentrating ability, and reduced total body water.\u003csup\u003e[\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]\u003c/sup\u003e Medications may also exacerbate this predisposition. Clinical data reported that hypernatremia is present in approximately 2.0% of patients older than 65\u0026nbsp;years but in almost 4.8% of those older than 75\u0026nbsp;years admitted to the hospital.\u003csup\u003e[\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]\u003c/sup\u003e In a retrospective study involving 8,441 older patients admitted to the ICU, approximately 3.6% had hypernatremia on admission, and 15.3% developed hypernatremia during hospitalization;\u003csup\u003e[\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]\u003c/sup\u003e the mortality rate in those admitted with hypernatremia was approximately 33.3%, while patients without hypernatremia had a mortality rate of 18.1%.\u003csup\u003e[\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]\u003c/sup\u003e If patients had normal serum sodium levels on admission and developed mild hypernatremia (145.0\u0026ndash;150.0\u0026nbsp;mmol/L) or moderate to severe hypernatremia (\u0026gt;\u0026thinsp;150.0\u0026nbsp;mmol/L) in the ICU, the mortality rates increased to 29.5% and 46.2%, respectively.\u003csup\u003e[\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]\u003c/sup\u003e Other studies have confirmed these findings: mortality increases with increasing serum sodium level, and even mild hypernatremia is associated with significant mortality in hospitalized elderly patients, even after accounting for confounders.\u003csup\u003e[\u003cspan additionalcitationids=\"CR26\" citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eHyponatremia, defined as a serum sodium concentration below 135\u0026nbsp;mmol/L, is the most common electrolyte problem seen in hospitalized patients.\u003csup\u003e[\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]\u003c/sup\u003e Advanced age is an independent risk factor for the development of hyponatremia due to the decreased ability of the body to handle stresses related to salt and water balance. Moreover, drugs such as thiazides and nonsteroidal anti-inflammatory agents commonly used in this age group contribute to a decreased renal ability to excrete free water. Critically ill patients also demonstrate impaired renal capacity to excrete free water. Hyponatremia has been observed in 14.5\u0026ndash;37.9% of patients upon hospital admission,\u003csup\u003e[\u003cspan additionalcitationids=\"CR29\" citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e]\u003c/sup\u003e while rates of hospital-acquired hyponatremia range from 11.0 to 38.2%.\u003csup\u003e[\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e, \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e, \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e]\u003c/sup\u003e Mortality rates vary significantly based on the population studied, and in several studies, hyponatremia has been associated with an increased risk of death.\u003csup\u003e[\u003cspan additionalcitationids=\"CR29 CR30 CR31\" citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e]\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eThe treatment and prevention of AKI remains a major challenge for intensive care physicians and nephrologists. When managing severe AKI, whether to provide renal replacement therapy (RRT) and, if it is needed, when to initiate it are unclear. It is widely accepted that if there are life-threatening complications of AKI, such as hyperkalemia or metabolic acidosis, RRT should be initiated immediately. However, in the absence of such complications, the appropriate timing of the initiation of RRT remains unclear. A significant interaction between serum sodium levels and mortality was observed in our study (\u003cspan type=\"Italic\" class=\"Italic\" name=\"Emphasis\"\u003eP\u003c/span\u003e interaction: \u0026lt;0.001 for 90-day mortality and \u0026lt;\u0026thinsp;0.001 for 1-year mortality). Across different sodium strata, higher and lower serum sodium levels were both associated with an increased risk of mortality among patients with AKI. Hypernatremia has been poorly assessed in AKI, probably because according to a previous report, more AKI patients suffer from hyponatremia (Na\u003csup\u003e+\u003c/sup\u003e \u0026lt; 135\u0026nbsp;mmol/L) than hypernatremia (Na\u003csup\u003e+\u003c/sup\u003e \u0026gt; 145\u0026nbsp;mmol/L) (27.0% vs 5.7%) when admitted to the ICU.\u003csup\u003e[\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e]\u003c/sup\u003e However, the percentage of patients with hypernatremia was 32.1% compared with 20.3% of the patients with hyponatremia in our study. Both hyponatremia and hypernatremia can have direct adverse effects on the function of various organs, including the brain, heart, and musculoskeletal system, and subsequently increase mortality. Dysnatremia may be a potential target for correction for clinicians. However, whether correcting dysnatremia could improve outcomes should be evaluated in future studies.\u003c/p\u003e "},{"header":"Strengths And Limitations","content":" \u003cp\u003eThere were also several limitations of this study. First, this was a single-center retrospective analysis, and we could only establish an association rather than a causal relationship. In addition, different results could be reached when using patient records from other centers. Therefore, subject selection bias cannot be ignored. Second, we only analyzed sodium levels at the time of AKI diagnosis, and these levels could change over time (e.g., initiating electrolyte therapy). Third, although we attempted to account for a number of potential confounders in the multivariable analyses, it is plausible that other unidentified variables may have influenced the results. Finally, we used all-cause mortality rather than cause-specific mortality, which was also a major limitation.\u003c/p\u003e "},{"header":"Conclusion","content":" \u003cp\u003eSodium levels outside the interval of 130.0\u0026ndash;141.9\u0026nbsp;mmol/L were associated with increased 90-day mortality and 1-year mortality risks in very elderly AKI patients.\u003c/p\u003e "},{"header":"Abbreviations","content":" \u003cp\u003eAKI = acute kidney injury; BMI\u0026thinsp;=\u0026thinsp;body mass index; COPD\u0026thinsp;=\u0026thinsp;chronic obstructive pulmonary disease; eGFR\u0026thinsp;=\u0026thinsp;estimated glomerular fitration rate; MAP\u0026thinsp;=\u0026thinsp;mean aortic pressure; 1\u0026nbsp;mmHg, 0.133\u0026nbsp;kPa. MV\u0026thinsp;=\u0026thinsp;mechanical ventilation; Scr\u0026thinsp;=\u0026thinsp;serum creatinine; BUN = blood urea nitrogen; BG\u0026thinsp;=\u0026thinsp;blood glucose; RRT\u0026thinsp;=\u0026thinsp;renal replacement therapy\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis manuscript was edited for English language by American Journal Experts (AJE).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was funded by grants from the National Natural Science Foundation of China (No. 81871587), National Clinical Research Center for Geriatric Diseases of China (No. NCRCG-PLAGH-2017008) and WU JIEPING MEDICAL FOUNDATION (No. HRJJ20171039).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and material\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll data generated and/or analyzed during this study are included in this published article.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eQL participated in the conception and design of the study, did the statistical analyses, reviewed the literature, analyzed and interpreted the data, and drafted the manuscript. LP and ZM participated in the conception and design of the study, acquisition of data, analyzed and interpreted the data. HK was involved in design and in acquisition of data and helped to revise the manuscript critically for important content. FZ conceived of the study, participated in its design, and helped to revise manuscript. All authors read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical approval\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study design was approved by the Clinical Ethics Committee of the Chinese PLA General Hospital.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInformed consent \u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFor this type of study, formal consent is not required.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe manuscript has been read and its submission approved by all coauthors.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eLee SA, Cozzi M, Bush EL, Rabb H: Distant Organ Dysfunction in Acute Kidney Injury: A Review. 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Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association 2008, 23(5):1562-1568.\u003c/li\u003e\n\u003cli\u003eGregor, Lindner, and, Georg-Christian, Funk, and, Christoph, Schwarz, and, Nikolaus: Hypernatremia in the Critically Ill Is an Independent Risk Factor for Mortality.\u003c/li\u003e\n\u003cli\u003eFunk GC, Lindner G, Druml W, Metnitz B, Schwarz C, Bauer P, Metnitz PG: Incidence and prognosis of dysnatremias present on ICU admission. Intensive care medicine 2010, 36(2):304-311.\u003c/li\u003e\n\u003cli\u003eWald R, Jaber BL, Price LL, Upadhyay A, Madias NE: Impact of hospital-associated hyponatremia on selected outcomes. 2010, 170(3):294.\u003c/li\u003e\n\u003cli\u003eWaikar SS, Mount DB, Curhan GC: Mortality after hospitalization with mild, moderate, and severe hyponatremia. Am J Med 2009, 122(9):857-865.\u003c/li\u003e\n\u003cli\u003eStelfox HT, Ahmed SB, Zygun D, Khandwala F, Laupland K: Characterization of intensive care unit acquired hyponatremia and hypernatremia following cardiac surgery. Canadian journal of anaesthesia = Journal canadien d'anesthesie 2010, 57(7):650-658.\u003c/li\u003e\n\u003cli\u003eStelfox HT, Ahmed SB, Khandwala F, Zygun D, Shahpori R, Laupland K: The epidemiology of intensive care unit-acquired hyponatraemia and hypernatraemia in medical-surgical intensive care units. Critical care 2008, 12(6):R162.\u003c/li\u003e\n\u003cli\u003ePeres LAB, Wandeur V, Matsuo T: Predictors of acute kidney injury and mortality in an Intensive Care Unit. 2015.\u003c/li\u003e\n\u003c/ol\u003e\n"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":" Serum sodium, acute kidney injury, very elderly, mortality","lastPublishedDoi":"10.21203/rs.3.rs-16898/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-16898/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eBackground: Patients suffering from acute kidney injury (AKI) have been associated with impaired sodium. However, studies on the association of dysnatremia with all-cause mortality risk in AKI patients are particularly lacking. We examined the relationship between different levels of serum sodium and mortality among very elderly patients with AKI. \u003c/p\u003e\u003cp\u003eMethods: We retrospectively enrolled very elderly patients (≥ 75 years) from Chinese PLA General Hospital from 2007, to 2018. All-cause mortality was examined according to eight predefined sodium levels: \u0026lt;130.0 mmol/L, 130.0–134.9 mmol/L, 135.0–137.9 mmol/L, 138.0–141.9 mmol/L, 142.0–144.9 mmol/L, 145.0–147.9 mmol/L, 148.0–151.9 mmol/L, and ≥152.0 mmol/L. We estimated the risk of all-cause mortality using a multivariable adjusted Cox proportional hazard model, with a normal serum potassium level of 135.0–137.9 mmol/L as a reference. \u003c/p\u003e\u003cp\u003eResults: In total, 744 geriatric patients were suitable for the final evaluation. Among them, 260 (34.9%) died within 90 days; during the 1-year follow-up, 5 patients were lost to follow-up, and 383 (51.8%) died. After 90 days, the mortality rates in the eight strata were 36.1, 27.8, 19.6, 24.4, 30.7, 48.6, 52.8, and 57.7%, respectively. In the multivariable adjusted analysis, patients with sodium levels \u0026lt;130.0 mmol/L [hazard ratio (HR): 2.247; 95% confidence interval (CI): 1.117–4.521], from 142.0 to 144.9 mmol/L (HR: 1.964; 95% CI: 1.100–3.508), from 145.0 to 147.9 mmol/L (HR: 2.942; 95% CI: 1.693–5.114), from 148.0 to 151.9 mmol/L (HR: 3.455; 95% CI: 2.009–5.944), and ≥152.0 mmol/L (HR: 3.587; 95% CI: 2.151–5.983) had an increased risk of all-cause mortality. After 1 year, the mortality rates in the eight strata were 58.3, 47.8, 33.7, 38.9, 45.5, 64.3, 69.4, and 78.4%, respectively. In the multivariable adjusted analysis, patients with sodium levels \u0026lt;130.0 mmol/L (HR: 1.944; 95% CI: 1.125–3.360), from 142.0 to 144.9 mmol/L (HR: 1.681; 95% CI: 1.062–2.660), from 145.0 to 147.9 mmol/L (HR: 2.631; 95% CI: 1.683–4.112), from 148.0 to 151.9 mmol/L (HR: 2.411; 95% CI: 1.552–3.744), and ≥152.0 mmol/L (HR: 3.037; 95% CI: 2.021–4.563) had an increased risk of all-cause mortality. \u003c/p\u003e\u003cp\u003eConclusion: Sodium levels outside the interval of 130.0–141.9 mmol/L were associated with increased risks of 90-day mortality and 1-year mortality in very elderly AKI patients.\u003c/p\u003e","manuscriptTitle":"Associations of serum sodium levels with mortality in very elderly acute kidney injury patients","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2020-03-12 14:45:59","doi":"10.21203/rs.3.rs-16898/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"b3a632fb-e48b-4194-853a-1fec7ddad7ef","owner":[],"postedDate":"March 12th, 2020","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":69193,"name":"Critical Care \u0026 Emergency Medicine"}],"tags":[],"updatedAt":"","versionOfRecord":[],"versionCreatedAt":"2020-03-12 14:45:59","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-16898","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-16898","identity":"rs-16898","version":["v1"]},"buildId":"ApUGefWb6u5IBVtyqm6d5","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}
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