Clinical correlates of hyponatremia among hospitalized heart failure patients at Jakaya Kikwete cardiac institute, Dar es Salaam
No Thumbnail Available
Date
2025
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Kairuki University
Abstract
Background: Hyponatremia is a frequent electrolyte disturbance in patients with heart failure (HF), associated with prolonged hospitalization, increased morbidity, and higher mortality. It results from hemodynamic alterations, neurohormonal activation, and medication effects, particularly diuretics. In sub-Saharan Africa, including Tanzania, data on its prevalence and clinical correlates remain limited. Understanding its magnitude among HF patients at JKCI is crucial for early identification and routine monitoring of serum sodium levels to prevent complications and improve outcomes.
Objective: To determine the clinical correlates of hyponatremia among hospitalized adult HF patients at JKCI, Dar es Salaam.
Methodology: A hospital-based cross-sectional study was conducted among adult HF patients admitted to JKCI. Sociodemographic characteristics, medical history, medication use, volume status, laboratory findings, and echocardiographic parameters were collected using a structured tool. Serum sodium was categorized into normal, mild, moderate, and severe hyponatremia, and volume status was used to classify hypovolemic, euvolemic, and hypervolemic hyponatremia. Data were analyzed using SPSS version 25. Descriptive statistics summarized participant data, chi-squared tests assessed associations, and Spearman’s correlation evaluated the relationship between ejection fraction (EF) and sodium levels.
Results: Of 133 HF patients, 67.6% had hyponatremia, mostly mild to moderate. Males had a slightly higher prevalence (68.1%) than females (67.2%). Common symptoms included fatigue (62.4%), nausea (42.1%), and headache (34.6%), with severity correlating significantly with sodium levels. Hyponatremia was more severe in single patients, and unexpectedly higher among those with higher education. Prevalence increased with older age (>60 years) and was more common in patients using diuretics, restricting salt, and those with reduced EF (HFrEF), where hypervolemic hyponatremia predominated. Hypertension was the most frequent comorbidity (91%) but was not statistically associated. Hyponatremia severity correlated strongly with NYHA functional class and chronicity of HF.
Conclusion: Hyponatremia is a common and under-recognized electrolyte imbalance among hospitalized HF patients at JKCI. Its occurrence was strongly linked to advanced NYHA class, diuretic use, salt restriction, comorbidities, older age, and reduced EF. Early recognition and management can reduce HF complications, hospital stay, and improve quality of life.
Recommendation: Routine sodium monitoring, individualized dietary advice, detailed volume assessment, and further longitudinal research are recommended to improve HF outcomes
Description
A dissertation submitted in partial fulfillment of the requirements for the degree of Master of Medicine in Internal Medicine at Kairuki university
Keywords
hyponatremia, heart failure, Tanzania cardiac institute
Citation
Nassor, Bilqis S., 2025. Clinical correlates of hyponatremia among hospitalized heart failure patients at Jakaya Kikwete cardiac institute, Dar es Salaam. Dissertation. Kairuki University