Impact of Hyponatremia after Renal Transplantation on Decline of Renal Function, Graft Loss and Patient Survival: A Prospective Cohort Study.

Hyponatremia is one of the most common electrolyte disorders observed in hospitalized and ambulatory patients. Hyponatremia is associated with increased falls, fractures, prolonged hospitalisation and mortality. The clinical importance of hyponatremia in the renal transplant field is not well established, so the aim of this study was to determine the relationships between hyponatremia and mortality as main outcome and renal function decline and graft loss as secondary outcome among a prospective cohort of renal transplant recipients. This prospective cohort study included 1315 patients between 1 May 2008 and 31 December 2014. Hyponatremia was defined as sodium concentration below 136 mmol/L at 6 months after transplantation. The main endpoint was mortality. A secondary composite endpoint was also defined as: rapid decline in renal function (≥5 mL/min/1.73 m <sup>2</sup> drop of the eGFR/year), graft loss or mortality. Mean sodium was 140 ± 3.08 mmol/L. 97 patients displayed hyponatremia with a mean of 132.9 ± 3.05 mmol/L. Hyponatremia at 6 months after transplantation was associated neither with mortality (HR: 1.02; p = 0.97, 95% CI: 0.47-2.19), nor with the composite outcome defined as rapid decline in renal function, graft loss or mortality (logrank test p = 0.9). Hyponatremia 6 months after transplantation is not associated with mortality in kidney allograft patients

Nesseltalgraben, a new reference section of the last glacial period in southern Germany

In the northern Alpine region only a few lacustrine sediment sequences are known from the period of the last glacial, regionally assigned as Würmian. Even less is known about Alpine palaeoenvironments prior to the last glacial maximum (LGM). The recently discovered sediment sections at the Nesseltalgraben site (northern Alps, southern Germany) presented here, comprise an approximately 27-m-high, predominantly lacustrine composite profile below coarse clastic sediments assigned to the LGM and underlain by Permian–Triassic evaporitic and sandy clayey sediments of the Haselgebirge and Werfen-Formation. The Würmian lake sediments consist of carbonate mud layers representing cooler phases, and organic rich layers (compressed peat, organic mud), that were deposited during warmer periods. Bulk organic geochemical analyses suggest that predominantly algal organic matter was deposited during the cooler periods, while higher fractions of terrestrial vascular plants were admixed during warmer phases. A diamict represents an erosional unconformity and cuts the sediment sequence into a lower and an upper part. Paleomagnetic, palynostratigraphic and radiocarbon analyses place the lower part into the Marine Isotope Stage (MIS) 5c (Lower Würmian), while the upper part covers at least the period from 45 to 31 ka cal BP (MIS 3, Middle Würmian). Different explanations for the origin and spatiotemporal extent of the palaeolake are discussed. The most plausible sedimentary deposition is the formation of the small-scaled lake in a sinkhole in the evaporitic Haselgebirge Formation. The results highlight the significance of the Nesseltalgraben site as a new reference section of the last glacial period in the Northern Calcareous Alps and call for the necessity of further geochronological and paleoenvironmental studies at that site