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Trace Elements in Medicine
International scientific and practical peer-reviewed journal
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V.N. Tsigan1, O.L. Boriskina1, A.A. Yakovenko2

1 Military Medical Academy named after S.M. Kirov MO R,

st. Academician Lebedeva, 37, St. Petersburg, 194044, Russia

2 First Pavlov St.-Petersburg State Medical University,
st. Lev Tolstoy, 6-8, St. Petersburg, 197022, Russia



ABSTRACT.  Hyponatremia can lead to deterioration of CNS function and muscle function. Studies indicate the importance of early recognition and treatment of hyponatremia as a risk factor for age-related diseases and impaired quality of life in the elderly. Chronic kidney disease (CKD) is associated with electrolyte abnormalities and skeletal muscle pathology, but studies describing the relationship between hyponatremia and sarcopenia to understand the pathogenetic mechanisms of the development of secondary sarcopenia in CKD and identify possible ways of its correction are currently insufficient. Aim of study: to investigate the relationship between hyponatremia and sarcopenia as a pathological condition characterised by a reduction in skeletal muscle mass and function in patients in patients receiving chronic haemodialysis for end-stage kidney disease.

In 196 patients diagnosed with ESKD receiving chronic haemodialysis therapy for more than one-year, routine examination and monitoring of biochemical parameters including serum sodium level, dynamometry, 4-metre walk test and bioimpedanceometry were performed to determine sarcopenia according to EWGSOP2 criteria.

Mild hyponatremia was identified in 47 (24%) participants, with more prevalence in women (63.8%) than men (36.2%) (χ2=5.086, p=0.024) and was independent of age p=0.176. Sarcopenia was diagnosed in 119 patients (60.7%). Statistically significant variations in grip strength, appendicular skeletal muscle mass (ASM), and appendicular skeletal muscle mass index (ASMI) were found in relation to sodium levels. Logistic regression analysis was performed to show that sodium level can be considered as a predictor of sarcopenia in patients receiving chronic haemodialysis treatment.

KEYWORDS: hyponatremia, sarcopenia, chronic kidney disease.