Improving the diagnostic workup of hyponatremia in the setting of kidney disease: a continuing medical education (CME) initiative View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2017-03

AUTHORS

Ladan Golestaneh, Joel Neugarten, William Southern, Faraj Kargoli, Amanda Raff

ABSTRACT

PURPOSE: Hyponatremia is a common electrolyte disorder and is associated with mortality. We examined the frequency of appropriate testing in response to an episode of inpatient hyponatremia in a large urban hospital to better inform our educational intervention. We then evaluated the impact of a live CME activity with a focus on CKD- and ESRD-associated hyponatremia physiology, on diagnostic practices of audience hospitalist attendings. METHODS: We performed a retrospective database analysis of all patients admitted to Montefiore Medical Center in 2014 to examine the performance of hospital staff in response to hyponatremia across all CKD stages. We then did a comparative analysis of diagnostic workup orders for hyponatremic patients admitted to audience members of a live CME activity in the 4 months prior as compared to the 4 months after the activity. RESULTS: The prevalence of hyponatremia was 27% in a cohort of hospitalized patients: 41% of these hyponatremia inpatients had CKD, and 11.4% had ESRD. Overall less than 10% of patients had orders written for serum and urine osmolality without a differential pattern based on CKD or ESRD diagnosis. Among the patients admitted to the CME audience hospitalists, urine/serum osmolality and urine sodium orders occurred infrequently overall and did not differ after vs. before the lecture. DISCUSSION: The frequency of appropriate diagnostic orders written in response to an episode of hyponatremia was very low and did not vary based on degree of CKD. A CME activity with an emphasis on the role of CKD/ESRD in diagnostic accuracy did not improve the order quality in a group of audience hospitalists. Efforts to improve the diagnostic workup of hyponatremia with concomitant kidney disease are crucial to proper management of these patients. More... »

PAGES

491-497

References to SciGraph publications

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s11255-017-1501-6

DOI

http://dx.doi.org/10.1007/s11255-017-1501-6

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1006736851

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/28091865


Indexing Status Check whether this publication has been indexed by Scopus and Web Of Science using the SN Indexing Status Tool
Incoming Citations Browse incoming citations for this publication using opencitations.net

JSON-LD is the canonical representation for SciGraph data.

TIP: You can open this SciGraph record using an external JSON-LD service: JSON-LD Playground Google SDTT

[
  {
    "@context": "https://springernature.github.io/scigraph/jsonld/sgcontext.json", 
    "about": [
      {
        "id": "http://purl.org/au-research/vocabulary/anzsrc-for/2008/1103", 
        "inDefinedTermSet": "http://purl.org/au-research/vocabulary/anzsrc-for/2008/", 
        "name": "Clinical Sciences", 
        "type": "DefinedTerm"
      }, 
      {
        "id": "http://purl.org/au-research/vocabulary/anzsrc-for/2008/11", 
        "inDefinedTermSet": "http://purl.org/au-research/vocabulary/anzsrc-for/2008/", 
        "name": "Medical and Health Sciences", 
        "type": "DefinedTerm"
      }, 
      {
        "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
        "name": "Adult", 
        "type": "DefinedTerm"
      }, 
      {
        "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
        "name": "Aged", 
        "type": "DefinedTerm"
      }, 
      {
        "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
        "name": "Aged, 80 and over", 
        "type": "DefinedTerm"
      }, 
      {
        "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
        "name": "Education, Medical, Continuing", 
        "type": "DefinedTerm"
      }, 
      {
        "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
        "name": "Female", 
        "type": "DefinedTerm"
      }, 
      {
        "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
        "name": "Glomerular Filtration Rate", 
        "type": "DefinedTerm"
      }, 
      {
        "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
        "name": "Guideline Adherence", 
        "type": "DefinedTerm"
      }, 
      {
        "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
        "name": "Hospitalists", 
        "type": "DefinedTerm"
      }, 
      {
        "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
        "name": "Humans", 
        "type": "DefinedTerm"
      }, 
      {
        "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
        "name": "Hyponatremia", 
        "type": "DefinedTerm"
      }, 
      {
        "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
        "name": "Interrupted Time Series Analysis", 
        "type": "DefinedTerm"
      }, 
      {
        "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
        "name": "Kidney Failure, Chronic", 
        "type": "DefinedTerm"
      }, 
      {
        "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
        "name": "Male", 
        "type": "DefinedTerm"
      }, 
      {
        "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
        "name": "Middle Aged", 
        "type": "DefinedTerm"
      }, 
      {
        "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
        "name": "Osmolar Concentration", 
        "type": "DefinedTerm"
      }, 
      {
        "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
        "name": "Practice Guidelines as Topic", 
        "type": "DefinedTerm"
      }, 
      {
        "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
        "name": "Practice Patterns, Physicians'", 
        "type": "DefinedTerm"
      }, 
      {
        "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
        "name": "Program Evaluation", 
        "type": "DefinedTerm"
      }, 
      {
        "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
        "name": "Severity of Illness Index", 
        "type": "DefinedTerm"
      }, 
      {
        "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
        "name": "Sodium", 
        "type": "DefinedTerm"
      }
    ], 
    "author": [
      {
        "affiliation": {
          "name": [
            "Montefiore Medical Center, Albert Einstein College of Medicine, 3450 Wayne AveSuite 5H, 10467, Bronx, NY, USA"
          ], 
          "type": "Organization"
        }, 
        "familyName": "Golestaneh", 
        "givenName": "Ladan", 
        "id": "sg:person.0747050400.84", 
        "sameAs": [
          "https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.0747050400.84"
        ], 
        "type": "Person"
      }, 
      {
        "affiliation": {
          "name": [
            "Montefiore Medical Center, Albert Einstein College of Medicine, 3450 Wayne AveSuite 5H, 10467, Bronx, NY, USA"
          ], 
          "type": "Organization"
        }, 
        "familyName": "Neugarten", 
        "givenName": "Joel", 
        "id": "sg:person.01220213202.20", 
        "sameAs": [
          "https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.01220213202.20"
        ], 
        "type": "Person"
      }, 
      {
        "affiliation": {
          "name": [
            "Montefiore Medical Center, Albert Einstein College of Medicine, 3450 Wayne AveSuite 5H, 10467, Bronx, NY, USA"
          ], 
          "type": "Organization"
        }, 
        "familyName": "Southern", 
        "givenName": "William", 
        "id": "sg:person.0774155445.28", 
        "sameAs": [
          "https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.0774155445.28"
        ], 
        "type": "Person"
      }, 
      {
        "affiliation": {
          "name": [
            "Montefiore Medical Center, Albert Einstein College of Medicine, 3450 Wayne AveSuite 5H, 10467, Bronx, NY, USA"
          ], 
          "type": "Organization"
        }, 
        "familyName": "Kargoli", 
        "givenName": "Faraj", 
        "id": "sg:person.01150256260.08", 
        "sameAs": [
          "https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.01150256260.08"
        ], 
        "type": "Person"
      }, 
      {
        "affiliation": {
          "name": [
            "Montefiore Medical Center, Albert Einstein College of Medicine, 3450 Wayne AveSuite 5H, 10467, Bronx, NY, USA"
          ], 
          "type": "Organization"
        }, 
        "familyName": "Raff", 
        "givenName": "Amanda", 
        "id": "sg:person.01330225635.16", 
        "sameAs": [
          "https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.01330225635.16"
        ], 
        "type": "Person"
      }
    ], 
    "citation": [
      {
        "id": "https://doi.org/10.1161/circulationaha.111.065391", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1001285749"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1093/intqhc/mzi025", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1005268002"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1530/eje-13-1020", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1007400562"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1001/archinternmed.2009.513", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1009412857"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1016/s1521-690x(12)70005-2", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1011454917"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "sg:pub.10.1186/s12916-014-0231-1", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1012245021", 
          "https://doi.org/10.1186/s12916-014-0231-1"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "sg:pub.10.1186/s12916-014-0231-1", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1012245021", 
          "https://doi.org/10.1186/s12916-014-0231-1"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1001/jama.1995.03530090032018", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1012615468"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1053/j.ajkd.2013.09.017", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1012758250"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "sg:pub.10.1186/1471-2369-14-276", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1014496958", 
          "https://doi.org/10.1186/1471-2369-14-276"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1053/j.ajkd.2013.02.367", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1019788976"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1542/peds.2013-0720", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1022251450"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1172/jci103829", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1023234652"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1136/postgradmedj-2014-132885", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1026073523"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1136/postgradmedj-2014-132885", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1026073523"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1111/nep.12634", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1030739995"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1016/j.amjmed.2009.01.027", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1031130367"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1111/echo.12505", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1031898650"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1016/j.jss.2012.03.017", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1032452843"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1159/000065371", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1033033170"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1053/j.ajkd.2012.09.019", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1035393705"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "sg:pub.10.1007/s00134-014-3210-2", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1038472214", 
          "https://doi.org/10.1007/s00134-014-3210-2"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1053/j.ajkd.2011.07.013", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1040216383"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1111/ans.12751", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1040646536"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1111/hdi.12447", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1040690799"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1093/ndt/gfu040", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1041159168"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.3109/0142159x.2013.847912", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1043295830"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "sg:pub.10.1186/s40697-016-0094-9", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1044392580", 
          "https://doi.org/10.1186/s40697-016-0094-9"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1016/j.amjmed.2010.07.029", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1047019236"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1016/j.amjmed.2007.09.001", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1051578815"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1001/jama.274.9.700", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1054159318"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1093/ageing/7.3.178", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1059370326"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1093/ndt/gfv341", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1059933195"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://app.dimensions.ai/details/publication/pub.1078351969", 
        "type": "CreativeWork"
      }, 
      {
        "id": "sg:pub.10.3275/8925", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1078713012", 
          "https://doi.org/10.3275/8925"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1080/08998280.2015.11929305", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1079159108"
        ], 
        "type": "CreativeWork"
      }
    ], 
    "datePublished": "2017-03", 
    "datePublishedReg": "2017-03-01", 
    "description": "PURPOSE: Hyponatremia is a common electrolyte disorder and is associated with mortality. We examined the frequency of appropriate testing in response to an episode of inpatient hyponatremia in a large urban hospital to better inform our educational intervention. We then evaluated the impact of a live CME activity with a focus on CKD- and ESRD-associated hyponatremia physiology, on diagnostic practices of audience hospitalist attendings.\nMETHODS: We performed a retrospective database analysis of all patients admitted to Montefiore Medical Center in 2014 to examine the performance of hospital staff in response to hyponatremia across all CKD stages. We then did a comparative analysis of diagnostic workup orders for hyponatremic patients admitted to audience members of a live CME activity in the 4\u00a0months prior as compared to the 4\u00a0months after the activity.\nRESULTS: The prevalence of hyponatremia was 27% in a cohort of hospitalized patients: 41% of these hyponatremia inpatients had CKD, and 11.4% had ESRD. Overall less than 10% of patients had orders written for serum and urine osmolality without a\u00a0differential pattern based on CKD or ESRD diagnosis. Among the patients admitted to the CME audience hospitalists, urine/serum osmolality and urine sodium orders occurred infrequently overall and did not differ after vs. before the lecture.\nDISCUSSION: The frequency of appropriate diagnostic orders written in response to an episode of hyponatremia was very low and did not vary based on degree of CKD. A CME activity with an emphasis on the role of CKD/ESRD in diagnostic accuracy did not improve the order quality in a group of audience hospitalists. Efforts to improve the diagnostic workup of hyponatremia with concomitant kidney disease are crucial to proper management of these patients.", 
    "genre": "research_article", 
    "id": "sg:pub.10.1007/s11255-017-1501-6", 
    "inLanguage": [
      "en"
    ], 
    "isAccessibleForFree": false, 
    "isFundedItemOf": [
      {
        "id": "sg:grant.2705247", 
        "type": "MonetaryGrant"
      }
    ], 
    "isPartOf": [
      {
        "id": "sg:journal.1014320", 
        "issn": [
          "0924-8455", 
          "1573-7306"
        ], 
        "name": "Geriatric Nephrology and Urology", 
        "type": "Periodical"
      }, 
      {
        "issueNumber": "3", 
        "type": "PublicationIssue"
      }, 
      {
        "type": "PublicationVolume", 
        "volumeNumber": "49"
      }
    ], 
    "name": "Improving the diagnostic workup of hyponatremia in the setting of kidney disease: a continuing medical education (CME) initiative", 
    "pagination": "491-497", 
    "productId": [
      {
        "name": "readcube_id", 
        "type": "PropertyValue", 
        "value": [
          "2016eb35a62d76ccf15b7a3bf6ea14d30b623acb9cd63807b3be1022d91870cd"
        ]
      }, 
      {
        "name": "pubmed_id", 
        "type": "PropertyValue", 
        "value": [
          "28091865"
        ]
      }, 
      {
        "name": "nlm_unique_id", 
        "type": "PropertyValue", 
        "value": [
          "0262521"
        ]
      }, 
      {
        "name": "doi", 
        "type": "PropertyValue", 
        "value": [
          "10.1007/s11255-017-1501-6"
        ]
      }, 
      {
        "name": "dimensions_id", 
        "type": "PropertyValue", 
        "value": [
          "pub.1006736851"
        ]
      }
    ], 
    "sameAs": [
      "https://doi.org/10.1007/s11255-017-1501-6", 
      "https://app.dimensions.ai/details/publication/pub.1006736851"
    ], 
    "sdDataset": "articles", 
    "sdDatePublished": "2019-04-11T09:33", 
    "sdLicense": "https://scigraph.springernature.com/explorer/license/", 
    "sdPublisher": {
      "name": "Springer Nature - SN SciGraph project", 
      "type": "Organization"
    }, 
    "sdSource": "s3://com-uberresearch-data-dimensions-target-20181106-alternative/cleanup/v134/2549eaecd7973599484d7c17b260dba0a4ecb94b/merge/v9/a6c9fde33151104705d4d7ff012ea9563521a3ce/jats-lookup/v90/0000000346_0000000346/records_99812_00000000.jsonl", 
    "type": "ScholarlyArticle", 
    "url": "https://link.springer.com/10.1007%2Fs11255-017-1501-6"
  }
]
 

Download the RDF metadata as:  json-ld nt turtle xml License info

HOW TO GET THIS DATA PROGRAMMATICALLY:

JSON-LD is a popular format for linked data which is fully compatible with JSON.

curl -H 'Accept: application/ld+json' 'https://scigraph.springernature.com/pub.10.1007/s11255-017-1501-6'

N-Triples is a line-based linked data format ideal for batch operations.

curl -H 'Accept: application/n-triples' 'https://scigraph.springernature.com/pub.10.1007/s11255-017-1501-6'

Turtle is a human-readable linked data format.

curl -H 'Accept: text/turtle' 'https://scigraph.springernature.com/pub.10.1007/s11255-017-1501-6'

RDF/XML is a standard XML format for linked data.

curl -H 'Accept: application/rdf+xml' 'https://scigraph.springernature.com/pub.10.1007/s11255-017-1501-6'


 

This table displays all metadata directly associated to this object as RDF triples.

292 TRIPLES      21 PREDICATES      83 URIs      41 LITERALS      29 BLANK NODES

Subject Predicate Object
1 sg:pub.10.1007/s11255-017-1501-6 schema:about N16b1494bf86d464bb68d400830bf49b0
2 N26b19aebde3b4deea187bc9916462e5c
3 N324568f706be42f59e1eaf1d87a3d64b
4 N53615c9cdf1d414da541a7e1024b0078
5 N5fdac529e32c4bc3926173b369b2fe22
6 N672e5364e3fb416ca1d96aebc86971cd
7 N6c91a16a5302436f90e325edaba3b5a8
8 N6d8a81133a234d5ebbe45c4875c1ae1b
9 N72b91737960b4a6e92e1c2cd8fd76631
10 N9ee871c160ed44da808db5bdd93811b0
11 Na601356240f64915897fad5ec26be126
12 Nbb762b95802245f28149c987c288a009
13 Nc9382419429a4e3282d3486617b38488
14 Ncdc7deebcf6448edba33e6d162d8022d
15 Ncf75e7775a2e4025ace115c37a2a49c1
16 Nd03191b378564542b59e3ab330526460
17 Ne17a47f3cba44b49bd4d75f304c1b270
18 Nf5f28f9d47404c5e9549d3079d71a7f4
19 Nfdcca7e79b4f4ac78a9ace871240aaf1
20 Nff7b7ea67f8f4a3eb4f2908d1d341ec5
21 anzsrc-for:11
22 anzsrc-for:1103
23 schema:author N946a3da04890455a9f01f3599784d3a4
24 schema:citation sg:pub.10.1007/s00134-014-3210-2
25 sg:pub.10.1186/1471-2369-14-276
26 sg:pub.10.1186/s12916-014-0231-1
27 sg:pub.10.1186/s40697-016-0094-9
28 sg:pub.10.3275/8925
29 https://app.dimensions.ai/details/publication/pub.1078351969
30 https://doi.org/10.1001/archinternmed.2009.513
31 https://doi.org/10.1001/jama.1995.03530090032018
32 https://doi.org/10.1001/jama.274.9.700
33 https://doi.org/10.1016/j.amjmed.2007.09.001
34 https://doi.org/10.1016/j.amjmed.2009.01.027
35 https://doi.org/10.1016/j.amjmed.2010.07.029
36 https://doi.org/10.1016/j.jss.2012.03.017
37 https://doi.org/10.1016/s1521-690x(12)70005-2
38 https://doi.org/10.1053/j.ajkd.2011.07.013
39 https://doi.org/10.1053/j.ajkd.2012.09.019
40 https://doi.org/10.1053/j.ajkd.2013.02.367
41 https://doi.org/10.1053/j.ajkd.2013.09.017
42 https://doi.org/10.1080/08998280.2015.11929305
43 https://doi.org/10.1093/ageing/7.3.178
44 https://doi.org/10.1093/intqhc/mzi025
45 https://doi.org/10.1093/ndt/gfu040
46 https://doi.org/10.1093/ndt/gfv341
47 https://doi.org/10.1111/ans.12751
48 https://doi.org/10.1111/echo.12505
49 https://doi.org/10.1111/hdi.12447
50 https://doi.org/10.1111/nep.12634
51 https://doi.org/10.1136/postgradmedj-2014-132885
52 https://doi.org/10.1159/000065371
53 https://doi.org/10.1161/circulationaha.111.065391
54 https://doi.org/10.1172/jci103829
55 https://doi.org/10.1530/eje-13-1020
56 https://doi.org/10.1542/peds.2013-0720
57 https://doi.org/10.3109/0142159x.2013.847912
58 schema:datePublished 2017-03
59 schema:datePublishedReg 2017-03-01
60 schema:description PURPOSE: Hyponatremia is a common electrolyte disorder and is associated with mortality. We examined the frequency of appropriate testing in response to an episode of inpatient hyponatremia in a large urban hospital to better inform our educational intervention. We then evaluated the impact of a live CME activity with a focus on CKD- and ESRD-associated hyponatremia physiology, on diagnostic practices of audience hospitalist attendings. METHODS: We performed a retrospective database analysis of all patients admitted to Montefiore Medical Center in 2014 to examine the performance of hospital staff in response to hyponatremia across all CKD stages. We then did a comparative analysis of diagnostic workup orders for hyponatremic patients admitted to audience members of a live CME activity in the 4 months prior as compared to the 4 months after the activity. RESULTS: The prevalence of hyponatremia was 27% in a cohort of hospitalized patients: 41% of these hyponatremia inpatients had CKD, and 11.4% had ESRD. Overall less than 10% of patients had orders written for serum and urine osmolality without a differential pattern based on CKD or ESRD diagnosis. Among the patients admitted to the CME audience hospitalists, urine/serum osmolality and urine sodium orders occurred infrequently overall and did not differ after vs. before the lecture. DISCUSSION: The frequency of appropriate diagnostic orders written in response to an episode of hyponatremia was very low and did not vary based on degree of CKD. A CME activity with an emphasis on the role of CKD/ESRD in diagnostic accuracy did not improve the order quality in a group of audience hospitalists. Efforts to improve the diagnostic workup of hyponatremia with concomitant kidney disease are crucial to proper management of these patients.
61 schema:genre research_article
62 schema:inLanguage en
63 schema:isAccessibleForFree false
64 schema:isPartOf Nb25f7b0288704014bac7cd0bfed11296
65 Nf46f40a739a34b7583b8539f9f109ca1
66 sg:journal.1014320
67 schema:name Improving the diagnostic workup of hyponatremia in the setting of kidney disease: a continuing medical education (CME) initiative
68 schema:pagination 491-497
69 schema:productId N1508328fdd7d45b9a75e2862d3aac449
70 N908c78bd8edb435f9433009802034d62
71 Nb0bc04b2925e412697f23ddf39868011
72 Nd4cc7719275048cbb29e14afa32810a4
73 Nee9e9ea4cc23488f86e9691b30d1e630
74 schema:sameAs https://app.dimensions.ai/details/publication/pub.1006736851
75 https://doi.org/10.1007/s11255-017-1501-6
76 schema:sdDatePublished 2019-04-11T09:33
77 schema:sdLicense https://scigraph.springernature.com/explorer/license/
78 schema:sdPublisher Nb701c87eeefb41fb910609da6aad0209
79 schema:url https://link.springer.com/10.1007%2Fs11255-017-1501-6
80 sgo:license sg:explorer/license/
81 sgo:sdDataset articles
82 rdf:type schema:ScholarlyArticle
83 N1508328fdd7d45b9a75e2862d3aac449 schema:name readcube_id
84 schema:value 2016eb35a62d76ccf15b7a3bf6ea14d30b623acb9cd63807b3be1022d91870cd
85 rdf:type schema:PropertyValue
86 N16b1494bf86d464bb68d400830bf49b0 schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
87 schema:name Male
88 rdf:type schema:DefinedTerm
89 N1edb6c0b341a4ee6a1d2f6f12526848d rdf:first sg:person.0774155445.28
90 rdf:rest N69124796f90d428c859df120d89dab6a
91 N26b19aebde3b4deea187bc9916462e5c schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
92 schema:name Practice Guidelines as Topic
93 rdf:type schema:DefinedTerm
94 N324568f706be42f59e1eaf1d87a3d64b schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
95 schema:name Hospitalists
96 rdf:type schema:DefinedTerm
97 N53615c9cdf1d414da541a7e1024b0078 schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
98 schema:name Education, Medical, Continuing
99 rdf:type schema:DefinedTerm
100 N54e63e8b38284b77a31c56bc6d5f2f9a rdf:first sg:person.01330225635.16
101 rdf:rest rdf:nil
102 N5fdac529e32c4bc3926173b369b2fe22 schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
103 schema:name Female
104 rdf:type schema:DefinedTerm
105 N672e5364e3fb416ca1d96aebc86971cd schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
106 schema:name Hyponatremia
107 rdf:type schema:DefinedTerm
108 N69124796f90d428c859df120d89dab6a rdf:first sg:person.01150256260.08
109 rdf:rest N54e63e8b38284b77a31c56bc6d5f2f9a
110 N6c91a16a5302436f90e325edaba3b5a8 schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
111 schema:name Middle Aged
112 rdf:type schema:DefinedTerm
113 N6d8a81133a234d5ebbe45c4875c1ae1b schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
114 schema:name Sodium
115 rdf:type schema:DefinedTerm
116 N72b91737960b4a6e92e1c2cd8fd76631 schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
117 schema:name Guideline Adherence
118 rdf:type schema:DefinedTerm
119 N7c3953fb21b947cb91bc311327146298 schema:name Montefiore Medical Center, Albert Einstein College of Medicine, 3450 Wayne AveSuite 5H, 10467, Bronx, NY, USA
120 rdf:type schema:Organization
121 N8b60d3f9d4bb4fb9b565780936ab0760 schema:name Montefiore Medical Center, Albert Einstein College of Medicine, 3450 Wayne AveSuite 5H, 10467, Bronx, NY, USA
122 rdf:type schema:Organization
123 N8f47dad5fa9f426bb516cfcba843d1ea schema:name Montefiore Medical Center, Albert Einstein College of Medicine, 3450 Wayne AveSuite 5H, 10467, Bronx, NY, USA
124 rdf:type schema:Organization
125 N908c78bd8edb435f9433009802034d62 schema:name nlm_unique_id
126 schema:value 0262521
127 rdf:type schema:PropertyValue
128 N946a3da04890455a9f01f3599784d3a4 rdf:first sg:person.0747050400.84
129 rdf:rest Ncac9f04af6a84e02b4a69fd5ef522894
130 N9ee871c160ed44da808db5bdd93811b0 schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
131 schema:name Aged
132 rdf:type schema:DefinedTerm
133 Na601356240f64915897fad5ec26be126 schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
134 schema:name Glomerular Filtration Rate
135 rdf:type schema:DefinedTerm
136 Na94e4a352239410a88c94e73f91d5703 schema:name Montefiore Medical Center, Albert Einstein College of Medicine, 3450 Wayne AveSuite 5H, 10467, Bronx, NY, USA
137 rdf:type schema:Organization
138 Nb0bc04b2925e412697f23ddf39868011 schema:name dimensions_id
139 schema:value pub.1006736851
140 rdf:type schema:PropertyValue
141 Nb25f7b0288704014bac7cd0bfed11296 schema:issueNumber 3
142 rdf:type schema:PublicationIssue
143 Nb701c87eeefb41fb910609da6aad0209 schema:name Springer Nature - SN SciGraph project
144 rdf:type schema:Organization
145 Nbb762b95802245f28149c987c288a009 schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
146 schema:name Osmolar Concentration
147 rdf:type schema:DefinedTerm
148 Nc9382419429a4e3282d3486617b38488 schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
149 schema:name Practice Patterns, Physicians'
150 rdf:type schema:DefinedTerm
151 Ncac9f04af6a84e02b4a69fd5ef522894 rdf:first sg:person.01220213202.20
152 rdf:rest N1edb6c0b341a4ee6a1d2f6f12526848d
153 Ncdc7deebcf6448edba33e6d162d8022d schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
154 schema:name Program Evaluation
155 rdf:type schema:DefinedTerm
156 Ncf75e7775a2e4025ace115c37a2a49c1 schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
157 schema:name Severity of Illness Index
158 rdf:type schema:DefinedTerm
159 Nd03191b378564542b59e3ab330526460 schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
160 schema:name Adult
161 rdf:type schema:DefinedTerm
162 Nd4cc7719275048cbb29e14afa32810a4 schema:name doi
163 schema:value 10.1007/s11255-017-1501-6
164 rdf:type schema:PropertyValue
165 Ne17a47f3cba44b49bd4d75f304c1b270 schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
166 schema:name Kidney Failure, Chronic
167 rdf:type schema:DefinedTerm
168 Ne2033a02eaf84e52bb5b2616bbb1c7b2 schema:name Montefiore Medical Center, Albert Einstein College of Medicine, 3450 Wayne AveSuite 5H, 10467, Bronx, NY, USA
169 rdf:type schema:Organization
170 Nee9e9ea4cc23488f86e9691b30d1e630 schema:name pubmed_id
171 schema:value 28091865
172 rdf:type schema:PropertyValue
173 Nf46f40a739a34b7583b8539f9f109ca1 schema:volumeNumber 49
174 rdf:type schema:PublicationVolume
175 Nf5f28f9d47404c5e9549d3079d71a7f4 schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
176 schema:name Humans
177 rdf:type schema:DefinedTerm
178 Nfdcca7e79b4f4ac78a9ace871240aaf1 schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
179 schema:name Interrupted Time Series Analysis
180 rdf:type schema:DefinedTerm
181 Nff7b7ea67f8f4a3eb4f2908d1d341ec5 schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
182 schema:name Aged, 80 and over
183 rdf:type schema:DefinedTerm
184 anzsrc-for:11 schema:inDefinedTermSet anzsrc-for:
185 schema:name Medical and Health Sciences
186 rdf:type schema:DefinedTerm
187 anzsrc-for:1103 schema:inDefinedTermSet anzsrc-for:
188 schema:name Clinical Sciences
189 rdf:type schema:DefinedTerm
190 sg:grant.2705247 http://pending.schema.org/fundedItem sg:pub.10.1007/s11255-017-1501-6
191 rdf:type schema:MonetaryGrant
192 sg:journal.1014320 schema:issn 0924-8455
193 1573-7306
194 schema:name Geriatric Nephrology and Urology
195 rdf:type schema:Periodical
196 sg:person.01150256260.08 schema:affiliation N8f47dad5fa9f426bb516cfcba843d1ea
197 schema:familyName Kargoli
198 schema:givenName Faraj
199 schema:sameAs https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.01150256260.08
200 rdf:type schema:Person
201 sg:person.01220213202.20 schema:affiliation Ne2033a02eaf84e52bb5b2616bbb1c7b2
202 schema:familyName Neugarten
203 schema:givenName Joel
204 schema:sameAs https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.01220213202.20
205 rdf:type schema:Person
206 sg:person.01330225635.16 schema:affiliation N8b60d3f9d4bb4fb9b565780936ab0760
207 schema:familyName Raff
208 schema:givenName Amanda
209 schema:sameAs https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.01330225635.16
210 rdf:type schema:Person
211 sg:person.0747050400.84 schema:affiliation Na94e4a352239410a88c94e73f91d5703
212 schema:familyName Golestaneh
213 schema:givenName Ladan
214 schema:sameAs https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.0747050400.84
215 rdf:type schema:Person
216 sg:person.0774155445.28 schema:affiliation N7c3953fb21b947cb91bc311327146298
217 schema:familyName Southern
218 schema:givenName William
219 schema:sameAs https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.0774155445.28
220 rdf:type schema:Person
221 sg:pub.10.1007/s00134-014-3210-2 schema:sameAs https://app.dimensions.ai/details/publication/pub.1038472214
222 https://doi.org/10.1007/s00134-014-3210-2
223 rdf:type schema:CreativeWork
224 sg:pub.10.1186/1471-2369-14-276 schema:sameAs https://app.dimensions.ai/details/publication/pub.1014496958
225 https://doi.org/10.1186/1471-2369-14-276
226 rdf:type schema:CreativeWork
227 sg:pub.10.1186/s12916-014-0231-1 schema:sameAs https://app.dimensions.ai/details/publication/pub.1012245021
228 https://doi.org/10.1186/s12916-014-0231-1
229 rdf:type schema:CreativeWork
230 sg:pub.10.1186/s40697-016-0094-9 schema:sameAs https://app.dimensions.ai/details/publication/pub.1044392580
231 https://doi.org/10.1186/s40697-016-0094-9
232 rdf:type schema:CreativeWork
233 sg:pub.10.3275/8925 schema:sameAs https://app.dimensions.ai/details/publication/pub.1078713012
234 https://doi.org/10.3275/8925
235 rdf:type schema:CreativeWork
236 https://app.dimensions.ai/details/publication/pub.1078351969 schema:CreativeWork
237 https://doi.org/10.1001/archinternmed.2009.513 schema:sameAs https://app.dimensions.ai/details/publication/pub.1009412857
238 rdf:type schema:CreativeWork
239 https://doi.org/10.1001/jama.1995.03530090032018 schema:sameAs https://app.dimensions.ai/details/publication/pub.1012615468
240 rdf:type schema:CreativeWork
241 https://doi.org/10.1001/jama.274.9.700 schema:sameAs https://app.dimensions.ai/details/publication/pub.1054159318
242 rdf:type schema:CreativeWork
243 https://doi.org/10.1016/j.amjmed.2007.09.001 schema:sameAs https://app.dimensions.ai/details/publication/pub.1051578815
244 rdf:type schema:CreativeWork
245 https://doi.org/10.1016/j.amjmed.2009.01.027 schema:sameAs https://app.dimensions.ai/details/publication/pub.1031130367
246 rdf:type schema:CreativeWork
247 https://doi.org/10.1016/j.amjmed.2010.07.029 schema:sameAs https://app.dimensions.ai/details/publication/pub.1047019236
248 rdf:type schema:CreativeWork
249 https://doi.org/10.1016/j.jss.2012.03.017 schema:sameAs https://app.dimensions.ai/details/publication/pub.1032452843
250 rdf:type schema:CreativeWork
251 https://doi.org/10.1016/s1521-690x(12)70005-2 schema:sameAs https://app.dimensions.ai/details/publication/pub.1011454917
252 rdf:type schema:CreativeWork
253 https://doi.org/10.1053/j.ajkd.2011.07.013 schema:sameAs https://app.dimensions.ai/details/publication/pub.1040216383
254 rdf:type schema:CreativeWork
255 https://doi.org/10.1053/j.ajkd.2012.09.019 schema:sameAs https://app.dimensions.ai/details/publication/pub.1035393705
256 rdf:type schema:CreativeWork
257 https://doi.org/10.1053/j.ajkd.2013.02.367 schema:sameAs https://app.dimensions.ai/details/publication/pub.1019788976
258 rdf:type schema:CreativeWork
259 https://doi.org/10.1053/j.ajkd.2013.09.017 schema:sameAs https://app.dimensions.ai/details/publication/pub.1012758250
260 rdf:type schema:CreativeWork
261 https://doi.org/10.1080/08998280.2015.11929305 schema:sameAs https://app.dimensions.ai/details/publication/pub.1079159108
262 rdf:type schema:CreativeWork
263 https://doi.org/10.1093/ageing/7.3.178 schema:sameAs https://app.dimensions.ai/details/publication/pub.1059370326
264 rdf:type schema:CreativeWork
265 https://doi.org/10.1093/intqhc/mzi025 schema:sameAs https://app.dimensions.ai/details/publication/pub.1005268002
266 rdf:type schema:CreativeWork
267 https://doi.org/10.1093/ndt/gfu040 schema:sameAs https://app.dimensions.ai/details/publication/pub.1041159168
268 rdf:type schema:CreativeWork
269 https://doi.org/10.1093/ndt/gfv341 schema:sameAs https://app.dimensions.ai/details/publication/pub.1059933195
270 rdf:type schema:CreativeWork
271 https://doi.org/10.1111/ans.12751 schema:sameAs https://app.dimensions.ai/details/publication/pub.1040646536
272 rdf:type schema:CreativeWork
273 https://doi.org/10.1111/echo.12505 schema:sameAs https://app.dimensions.ai/details/publication/pub.1031898650
274 rdf:type schema:CreativeWork
275 https://doi.org/10.1111/hdi.12447 schema:sameAs https://app.dimensions.ai/details/publication/pub.1040690799
276 rdf:type schema:CreativeWork
277 https://doi.org/10.1111/nep.12634 schema:sameAs https://app.dimensions.ai/details/publication/pub.1030739995
278 rdf:type schema:CreativeWork
279 https://doi.org/10.1136/postgradmedj-2014-132885 schema:sameAs https://app.dimensions.ai/details/publication/pub.1026073523
280 rdf:type schema:CreativeWork
281 https://doi.org/10.1159/000065371 schema:sameAs https://app.dimensions.ai/details/publication/pub.1033033170
282 rdf:type schema:CreativeWork
283 https://doi.org/10.1161/circulationaha.111.065391 schema:sameAs https://app.dimensions.ai/details/publication/pub.1001285749
284 rdf:type schema:CreativeWork
285 https://doi.org/10.1172/jci103829 schema:sameAs https://app.dimensions.ai/details/publication/pub.1023234652
286 rdf:type schema:CreativeWork
287 https://doi.org/10.1530/eje-13-1020 schema:sameAs https://app.dimensions.ai/details/publication/pub.1007400562
288 rdf:type schema:CreativeWork
289 https://doi.org/10.1542/peds.2013-0720 schema:sameAs https://app.dimensions.ai/details/publication/pub.1022251450
290 rdf:type schema:CreativeWork
291 https://doi.org/10.3109/0142159x.2013.847912 schema:sameAs https://app.dimensions.ai/details/publication/pub.1043295830
292 rdf:type schema:CreativeWork
 




Preview window. Press ESC to close (or click here)


...