The Prevalence of Hyponatremia in Pulmonary Tuberculosis Patients, a Tertiary Care Hospital Experience from Pakistan

Introduction: Tuberculosis (TB) is one of the major public health problems in Pakistan. Our country ranks fifth in tuberculosis high-burden countries worldwide. Hyponatremia is considered as one of the most common and important electrolyte abnormality in Pulmonary TB (PTB) patients. This study will show the prevalence of hyponatremia in PTB in our population. Objective: To evaluate the prevalence of hyponatremia in pulmonary tuberculosis patients. Study Design: Cross-sectional, descriptive study at Jinnah postgraduate medical centre Karachi from August 2017 to August 2018. Material and Methods: In this cross-sectional study, all patients with TB admitted in chest ward were enrolled. Patients having tuberculous meningitis, syndrome of inappropriate Ant diuretic hormone (SIADH), Renal failure, pneumonia, Cirrhosis taking medicines (diuretics, ACEI, and ARBs) were excluded. A pre-designed questionnaire was used to assess hyponatremia and its potential causes other than TB. Chi-square or Fischer exact test was used to identify factors associated with hyponatremia. Results: Ninety-six patients with mean age were 40.14 ± 13.02 years (ranging 18 - 65 years). Predominantly, patients were females 50 (52.08%). Overall Serum Na, Mean ± SD was 130.53 ± 6.99 (Ranging 110 - 146). Sixty one patients (63.5%) were younger than 40 years. Forty patients (41.66%) were smokers: 16 (16.7%) had diabetes mellitus (DM), and 15 (15.6%) had hypertension. Sixty-nine (71.87%) patients had hyponatremia of which 45 (73.77%) were less than 40 years (p = 0.375). Diabetes mellitus, female gender, smoking, hypertension and duration of disease were not associated with increased risk of hyponatremia having P Values: p = 0.082, p = 0.39, p = 0.57, p = 0.20 and p = 0.45 respectively. Conclusion: Hyponatremia is associated with tuberculosis and is more common with diabetes, hypertension, smoking and young age.