Key result
A high initial serum sodium to chloride ratio (>1.42) was associated with lower all-cause mortality versus the lowest quartile (<1.33) in peritoneal dialysis patients (HR 0.63; 95% CI 0.47-0.86).
Why the study?
Serum sodium to chloride ratio imbalance is linked to higher mortality in heart failure, but its prognostic significance in peritoneal dialysis patients remains unexplored.
Does a higher baseline serum sodium to chloride ratio improve survival in patients undergoing peritoneal dialysis?
Cohort (n=3,341)
Yes
Does a higher baseline serum sodium to chloride ratio improve survival in patients undergoing peritoneal dialysis?
Hazard Ratio: 0.63 (95% CI 0.47–0.86)
Higher initial serum sodium to chloride ratio is associated with significantly lower all-cause and cardiovascular mortality in patients undergoing peritoneal dialysis.
An imbalance in the serum sodium to chloride ratio (Na/Cl) was linked to higher mortality among heart failure patients. Nonetheless, the prognostic significance of Na/Cl in individuals undergoing peritoneal dialysis (PD) remains unexplored. This study seeks to explore the association between initial Na/Cl levels and mortality in PD patients. The study, conducted across multiple centers, included 3341 patients undergoing PD from January 1, 2005, to December 31, 2021. Patients were stratified into quartiles according to baseline Na/Cl and followed up for a median of 5.77 years. To explore the association between Na/Cl levels and mortality, we employed Cox proportional hazards models, competing risks models, and restricted cubic spline analysis. Of 3341 patients, 722 patients died, including 259 cardiovascular deaths. Following adjustments for comorbidities and multiple covariates, individuals in the highest Na/Cl quartile (>1.42) exhibited lower all-cause mortality (hazard ratio [HR] 0.63, 95% confidence interval [CI] 0.47-0.86) and cardiovascular mortality (HR 0.38, 95% CI 0.22-0.67) compared with those in the lowest quartile (<1.33). A similar pattern was also found when Na/Cl was dealt with continuous variables. Initial levels of Na/Cl at the start of PD were negatively correlated with all-cause mortality and cardiovascular mortality in PD patients.
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You et al. (2025) conducted a cohort in peritoneal dialysis (n=3,341). Highest serum sodium to chloride ratio (Na/Cl) quartile (>1.42) vs. Lowest Na/Cl quartile (<1.33) was evaluated on all-cause mortality (HR 0.63, 95% CI 0.47-0.86). A high initial serum sodium to chloride ratio (>1.42) was associated with lower all-cause mortality versus the lowest quartile (<1.33) in peritoneal dialysis patients (HR 0.63; 95% CI 0.47-0.86).
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