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논문 기본 정보

자료유형
학술저널
저자정보
Go Suryeong (Armed Forces Yangju Hospital) Sejoong Kim (Armed Forces Yangju Hospital) Son Hyung Eun (Department of Internal Medicine Seoul National University Bundang Hospital Seongnam Korea.) Ryu Ji Young (Department of Internal Medicine Seoul National University Bundang Hospital Seongnam Korea.) 양희진 (Hallym University Dongtan Sacred Heart Hospital Hwaseong Republic of Korea) 최선령 (한림대학교) 서장원 (Hallym University Dongtan Sacred Heart Hospital Hwaseong Republic of Korea) 조유환 (Seoul National University Bundang Hospital Seongnam Republic of Korea) 구자룡 (한림대학교) 백선하 (한림대학교)
저널정보
대한신장학회 Kidney Research and Clinical Practice Kidney Research and Clinical Practice Vol.40 No.3
발행연도
2021.9
수록면
371 - 382 (12page)
DOI
10.23876/j.krcp.20.233

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Background: Copeptin is secreted in equimolar amounts as arginine vasopressin, main hormone regulating body fluid homeostasis. A recent study reported a copeptin-based classification of osmoregulatory defects in syndromes of inappropriate antidiuresis that may aid in prediction of therapeutic success. We investigated usefulness of copeptin for differentiating etiologies of hyponatremia and pre- dicting efficacy and safety of hypertonic saline treatment in hyponatremic patients. Methods: We performed a multicenter, prospective cohort study of 100 inpatients with symptomatic hyponatremia (corrected serum sodium [sNa] ≤ 125 mmol/L) treated with hypertonic saline. Copeptin levels were measured at baseline and 24 hours after treatment initiation, and patients were classified as being below or above median of copeptin at baseline or at 24 hours, respectively. Correla- tions between target, under correction, and overcorrection rates of sNa within 24 hours/24?48 hours and copeptin levels at base- line/24 hours were analyzed. Results: Mean sNa and median copeptin levels were 117.9 and 16.9 pmol/L, respectively. Ratio of copeptin-to-urine sodium allowed for an improved differentiation among some (insufficient effective circulatory volume), but not all hyponatremia etiologic subgroups. Patients with below-median copeptin levels at baseline achieved a higher target correction rate in 6/24 hours (odds ratio [OR], 2.97; p = 0.02/OR, 6.21; p = 0.006). Patients with below-median copeptin levels 24 hours after treatment showed a higher overcorrection rate in next 24 hours (OR, 18.00, p = 0.02). Conclusion: There is a limited diagnostic utility of copeptin for differential diagnosis of hyponatremia. However, copeptin might be useful for predicting responses to hypertonic saline treatment in hyponatremic patients.

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