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Medical Costs of Abnormal Serum Sodium Levels

Alisa M. Shea^*, Bradley G. Hammill^*, Lesley H. Curtis^*,, Lynda A. Szczech^, and Kevin A. Schulman^*,

^* Center for Clinical and Genetic Economics, Duke Clinical Research Institute, Durham, North Carolina; Duke Clinical Research Institute, Durham, North Carolina; Division of General Internal Medicine and Division of Nephrology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina

Correspondence: Dr. Lesley H. Curtis, Center for Clinical and Genetic Economics, Duke Clinical Research Institute, PO Box 17969, Durham, NC 27715. Phone: 919-668-8101; Fax: 919-668-7124; E-mail: lesley.curtis{at}duke.edu

Received for publication July 11, 2007. Accepted for publication October 9, 2007.

An abnormal serum sodium level is the most common electrolyte disorder in the United States and can have a significant impact on morbidity and mortality. The direct medical costs of abnormal serum sodium levels are not well understood. The impact of hyponatremia and hypernatremia on 6-mo and 1-yr direct medical costs was examined by analyzing data from the Integrated HealthCare Information Services National Managed Care Benchmark Database. During the period analyzed, there were 1274 patients (0.8%) with hyponatremia (serum sodium <135 mmol/L), 162,829 (97.3%) with normal serum sodium levels, and 3196 (1.9%) with hypernatremia (>145 mmol/L). Controlling for age, sex, region, and comorbidities, hyponatremia was a significant independent predictor of costs at 6 mo (41.2% increase in costs; 95% confidence interval, 30.3% to 53.0%) and at 1 yr (45.7% increase; 95% confidence interval, 34.2% to 58.2%). Costs associated with hypernatremia were not significantly different from those incurred by patients with normal serum sodium. In conclusion, hyponatremia is a significant independent predictor of 6-mo and 1-yr direct medical costs.

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Copyright © 2008 by the American Society of Nephrology. Online ISSN: 1533-3450 Print ISSN: 1046-6673