Evidence mapPaperPMID 40317183Full record

ArticleThe Journal of clinical endocrinology and metabolism2025

Reassessing the Role of Copeptin in Emergency Department Admissions for Hypotonic Hyponatremia.

Alessandro Maria Berton, Emanuele Varaldo, Marco Zavattaro, Stefania Locatelli, Patrizia Ferrera, Emanuele Pivetta, Filippo Gatti, Nunzia Prencipe, Fabio Bioletto, Valentina Gasco and 6 more

Abstract read
In one paragraph

Article in The Journal of clinical endocrinology and metabolism, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Alessandro Maria BertonDivision of Endocrinology, Diabetology and Metabolism, Department of Medical Sciences, University of Turin, 10126 Turin, Italy.ORCID 0000-0002-4745-2624
Emanuele VaraldoDivision of Endocrinology, Diabetology and Metabolism, Department of Medical Sciences, University of Turin, 10126 Turin, Italy.ORCID 0000-0002-3772-8586
Marco ZavattaroDivision of Endocrinology, University Hospital "Maggiore della Carità,"  28100 Novara, Italy.
Stefania LocatelliDivision of Emergency Medicine and High Dependency Unit, Department of Medical Sciences, University Hospital "Città della Salute e della Scienza di Torino," 10126  Turin, Italy.
Patrizia FerreraDivision of Emergency Medicine and High Dependency Unit, Department of Medical Sciences, University Hospital "Città della Salute e della Scienza di Torino," 10126  Turin, Italy.
Emanuele PivettaDivision of Emergency Medicine and High Dependency Unit, Department of Medical Sciences, University Hospital "Città della Salute e della Scienza di Torino," 10126  Turin, Italy.
Filippo GattiDivision of Oncological Endocrinology, Department of Oncology, University Hospital "Città della Salute e della Scienza di Torino,"  10126 Turin, Italy.
Nunzia PrencipeDivision of Endocrinology, Diabetology and Metabolism, Department of Medical Sciences, University of Turin, 10126 Turin, Italy.
Fabio BiolettoDivision of Endocrinology, Diabetology and Metabolism, Department of Medical Sciences, University of Turin, 10126 Turin, Italy.ORCID 0000-0001-7550-7023
Valentina GascoDivision of Endocrinology, Diabetology and Metabolism, Department of Medical Sciences, University of Turin, 10126 Turin, Italy.
Andrea Silvio BensoDivision of Endocrinology, Diabetology and Metabolism, Department of Medical Sciences, University of Turin, 10126 Turin, Italy.
Silvia GrottoliDivision of Endocrinology, Diabetology and Metabolism, Department of Medical Sciences, University of Turin, 10126 Turin, Italy.
Paolo PasqueroDivision of Internal Medicine 1, Department of Medical Sciences, University Hospital "Città della Salute e della Scienza di Torino,"  10126 Turin, Italy.
Emanuela ArvatDivision of Oncological Endocrinology, Department of Oncology, University Hospital "Città della Salute e della Scienza di Torino,"  10126 Turin, Italy.ORCID 0000-0001-5689-4400
Ezio GhigoDivision of Endocrinology, Diabetology and Metabolism, Department of Medical Sciences, University of Turin, 10126 Turin, Italy.
Enrico LupiaDivision of Emergency Medicine and High Dependency Unit, Department of Medical Sciences, University Hospital "Città della Salute e della Scienza di Torino," 10126  Turin, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

contextThe role of copeptin in assessing hyponatremic patients at emergency department (ED) admission remains debated.

objectiveThis work aimed to assess copeptin's effectiveness in evaluating extracellular fluid (ECF) volume and its predictive value in hyponatremic adults admitted to the medical ED.

methodsThis work comprises a report from the IPSO-URG, a prospective cohort study with recruitment from June 2018 to August 2019 and 6-month follow-up. The setting is a medical ED of a single tertiary center. Patients included a consecutive sample of 123 adults with hyponatremia confirmed by direct and indirect ion-selective electrode assay after glucose correction. Excluding 33 individuals with missing consent or criteria and 6 without hypotonic hyponatremia, 84 patients were analyzed. Data included symptoms, vital signs, ultrasound, medical history, Charlson Comorbidity Index, and pretreatment blood and urine samples. ECF status was reassessed post discharge by 3 endocrinologists, blinded to copeptin results, who classified cases etiologically and resolved disagreements through discussion. In-hospital and 6-month mortality were recorded.

resultsA copeptin-to-urinary sodium (u-Na) ratio less than or equal to 29.5 pmol/mmol increased the likelihood of preserved ECF more than 4-fold (odds ratio 4.28; P = .026), outperforming standard u-Na (area under the curve difference 0.177; P = .013). Copeptin predicted in-hospital mortality (hazard ratio [HR] 1.005), with greater than 60.1 pmol/L as the optimal cutoff (P = .0005). Copeptin (HR 1.005; P = .02), N-terminal prohormone of brain natriuretic peptide (HR 1.004; P = .031), and comorbidity burden (HR 1.207; P = .009) predicted 6-month mortality, with copeptin greater than 13.6 pmol/L indicating a more than 4-fold risk (HR 4.507; P = .0001).

conclusionMeasuring copeptin on ED admission in hypotonic hyponatremia aids diagnosis and mortality prediction. The copeptin/u-Na index more accurately identifies preserved ECF than the standard u-Na cutoff.

Indexed as

Emergency Service, HospitalGlycopeptidesHyponatremiaPatient AdmissionAdultAgedAged, 80 and overBiomarkersExtracellular FluidFemaleFollow-Up StudiesHospital MortalityHumansMaleMiddle AgedPredictive Value of TestsBiomarkerscopeptinsGlycopeptidesSodiumCharlson Comorbidity Indexextracellular fluid volumemortalityNT-proBNPplasma osmolalityurinary sodium

Identifiers

PMID40317183
PMCPMC12623048

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.