Prevalence and impact of hyponatremia in chronic obstructive pulmonary disease. A systematic review and meta-analysis.
Purnima Adhikari, Raju Rana, Rohini Punja et al.
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In 30 seconds
This systematic review and meta-analysis assessed the prevalence and reported impact of hyponatremia in adults with stable chronic obstructive pulmonary disease (COPD) or acute exacerbations (AECOPD). Eleven studies were included: three involving COPD and eight involving AECOPD. Random-effects pooled prevalence was 14% (95% CI: 4%-28%) in COPD and 19% (95% CI: 9%-32%) in AECOPD. Heterogeneity was substantial in both groups, and most included studies did not find hyponatremia associated with AECOPD mortality.
Key findings
- Pooled hyponatremia prevalence in COPD was 14% (95% CI: 4%-28%; I² = 98.3%, p < 0.0001).
- In AECOPD, pooled prevalence was 19% (95% CI: 9%-32%; I² = 98.8%, p < 0.0001).
- Most included studies found no association between hyponatremia and mortality in AECOPD.
Why it matters
Hyponatremia was reported in both stable COPD and acute exacerbations, making it a relevant electrolyte abnormality in these populations. However, the very high heterogeneity means pooled prevalence estimates may not represent rates consistently across settings. The review also indicates that evidence linking hyponatremia to AECOPD mortality is not consistent with an association in most included studies.
What to keep in mind
The pooled estimates had substantial heterogeneity (I² > 98%), limiting their precision and generalisability. The review also notes the need for standardized diagnostic criteria and larger studies.