Effect of Nephrology Consultation on Hyponatremia Outcomes and Length of Hospital Stay

Background: Hyponatremia is common in hospitalized patients and linked to higher morbidity and mortality. Timely intervention is vital, but the impact of nephrology consultation on outcomes remains unclear. Methods: A retrospective cohort study of 423 patients with hyponatremia (serum sodium <130 mEq/L) who were admitted at NYP-Queens between July 1, 2023, and June 30, 2024. Patients were categorized into three groups based on the timing of nephrology consultation: early =< 48 hrs., late > 48 hrs., and no consultation. Primary and secondary outcomes were analyzed using multivariate regression models. Results: A total of 423 patients were included, with 173 (41%) early, 83 (20%) late, and 167 (39%) no consultation. The median age was 76 years, and 52% were females. Hypertension (70%) and diabetes mellitus (30%) were the most common comorbidities. Patients in the early consultation group had lower initial serum sodium levels, with 31% with sodium <120 mEq/L compared to 13% in the no-consultation group. Inpatient mortality was 2.6% with no significant differences between groups (p=0.6). The early consultation group had a significantly longer median hospital stay compared to the no-consultation group (p<0.001). Hypertonic saline was used more frequently in the early consultation group. The rate of correction (slow < 6, average 6-10, or rapid > 10 mEq/day) was similar between groups. No neurological complications were observed. Conclusion: Nephrology consultation was linked to longer hospital stays and targeted interventions like hypertonic saline use, without significant differences in mortality or correction rates. This suggests nephrology involvement supports individualized treatment without altering overall outcomes.Outcomes by Consultation Group