Influence of Serum Sodium Levels on Bone Metabolism and Turnover in Hospitalized Patients

Influence of Serum Sodium Levels on Bone Metabolism and Turnover in Hospitalized Patients - A Prospective Study (BONA-Trial)

In this study, the possible role of serum sodium concentration and its changes on bone markers in hospitalized, hyponatremic patients is determined. Therefore, it is investigated whether in hospitalized, hyponatremic patients the level of carboxy-terminal collagen crosslinks (CTX) is modified by changes in plasma sodium concentration, independently from the aetiology of hyponatremia.

Inclusion Criteria:

• Adult hospitalized patients with non-hypertonic hyponatremia: serum sodium < 130 mmol/l, serum osmolality < 300 milliosmol /kg
• age 18 to 99-year-old
• Informed consent as documented by signature

Exclusion Criteria:

• Severe symptomatic hyponatremia in need of intensive care treatment
• Hypertonic hyponatremia with serum osmolality > 300 mOsm/kg
• End of life care (palliative treatment)
• End stage kidney disease (dialysis)
• Acute liver failure
• Wernicke encephalopathy
• Hepatic encephalopathy during last 2 months
• Hepato-renal syndrome
• Any bone disease requiring treatment in the last three years
• History of fragility fractures
• Pre-menopausal women
• Hypogonadism (diagnosed before hospitalization)
• Hyperthyroidism
• Steroid therapy