Renal Fractional Excretion of Sodium in Relation to Arterial Blood Gas and Spirometric Parameters in Chronic Obstructive Pulmonary Disease

Arterial gas derangement could change urinary sodium excretion in Chronic Obstructive Pulmonary Disease (COPD) patients.There are very few and conflicting data in regards to the measurement of fractional excretion of sodium in COPD patients. The main aim of this study was to assess the relationship between renal fractional excretion of sodium(FeNa) with arterial blood gas and spirometric parameters in COPD. This study was a cross-sectional study performed on 40 consecutive stable COPD outpatients in 2 main general hospitals (Emam Reza, Ghaem) in Mashhad/Iran between 2011 and 2012. We investigated the relationship of renal FeNa with arterial blood gas parameters including HCO3, PH, PaCO2 and PaO2, and spirometric parameters. Analysis was done by SPSS v16 with a statistically meaningful p value of less than 0.05. Mean age was 65.97±10.77 SD years and female to male ratio was 0.26. A renal FeNa of less than 1% was presented in 27% patients. There was a significant, positive relationship between renal FeNa and PaO2 (P=0.005, r=0.456). The correlations between PaCO2, HCO3, PH and spirometric parameters were not seen (P>0.05), but there was a significant relationship between Urine Na and PaO2. Outstanding, it seems likely that kidneys of COPD patients are responsible for sodium retaining state particularly in the presence of hypoxemia. This study indicates that in COPD patients, PaO2 but not PaCO2 is related to renal FeNa which shows the probable role of hypoxemia on sodium output in COPD patients. However, some caution is needed for interpretation of the probable role of hypercapnia on sodium retention in COPD.