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Prevalence of hyponatremia in pulmonary tuberculosis A pilot study from a tertiary care center in south India

Bhanu Rekha Bokam, Vijayalakshmi Udipi Badikillaya.

Background: Pulmonary tuberculosis (PTB) is one of the common illnesses in developing countries which can present with various clinical manifestations. TB can induce hyponatremia via several mechanisms. The prevalence of hyponatremia is variable in previous studies.

Objectives: To study serum sodium levels and prevalence of hyponatremia in PTB patients.

Material and Methods: It was a cross-sectional study. Patients of 18 years and above, having active PTB over 2 years were included. Demographic and laboratory data of the patients were recorded and analysed.

Results: A total of 410 patients having PTB of an age ranging from 18 to 80 years; mean of 44.49 13.8 years were taken. About 55.12% were in the age group of 4060 years and 72.2% were males. Out of 410, 254 (61.95%) had hyponatremia, i.e., serum sodium < 135 mmol/L in which 182 (71.65%) were males and 72(28.34%) females. Most patients 156 (38.05%) had mild hyponatremia, 72 had moderate and only 26 had severe hyponatremia. Briefly, 132(84%) in the mild hyponatremia category, 48(62.6%) in the moderate and 26(92.3%) in the severe hyponatremia were sputum AFB positive. Patients having extensive lung field lesions had severe hyponatremia (76.9%). Most patients were asymptomatic; only 6 patients with severe hyponatremia were hypotensive and 2 of them required vasopressors.

Conclusions: Hyponatremia was observed to the extent of 61% in patients with PTB, with mild and asymptomatic hyponatremia being more common. Severity of hyponatremia was directly proportional to sputum positivity and extensive involvement of pulmonary parenchymal lesions.

Key words: Hyponatremia, pulmonary tuberculosis, AFB

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