Women on diuretics have a higher risk of hospital admission because of hyponatremia than men

Purpose: Recent studies suggest that women are more susceptible to diuretic-induced hyponatremia resulting in hospital admission than men. The aim of this study was to confirm whether these sex differences in hyponatremia-related hospital admissions in diuretic users remain after adjusting for several confounding variables such as age, dose, and concurrent medication.Methods: In a case-control design nested in diuretic users, cases of hyponatremia asso-ciated hospital admissions between 2005 and 2017 were identified from the PHARMO Data Network. Cases were 1:10 matched to diuretic users as controls. Odds ratios (OR) with 95%CIs were calculated for women versus men and adjusted for potential con-founders (age, number of diuretics, other hyponatremia-inducing drugs, chronic disease score) using unconditional logistic regression analysis. A subgroup analysis was performed for specific diuretic groups (thiazides, loop diuretics and aldosterone antagonists).Results: Women had a statistically significantly higher risk of a hospital admission associated with hyponatremia than men while using diuretics (OR 1.86, 95%CI 1.64- 2.11). Adjusting for the potential confounders resulted in an increased risk for women compared to men (ORadj 2.65, 95% CI 2.31-3.04). This higher risk in women was also seen in the three subgroup analyses after adjustment.Conclusion: Our findings show a higher risk of hyponatremia-related hospital admis-sion in women than men while using diuretics. Further research is needed to under-stand the underlying mechanism of this sex difference to be able to provide sex-specific recommendations.

Automated summary

Recent studies indicate that women using diuretics have a higher risk of hospital admission due to diuretic-induced hyponatremia compared to men. This study aimed to determine whether these sex differences persist after adjusting for confounding variables.