低钠血症与恶性肿瘤患者的预后较差相关。然而，缺乏关于流行病学和危险因素的当代队列数据。 在这项单中心回顾性队列研究中，纳入了 2018 年至 2020 年在名古屋市立大学医院接受静脉注射抗肿瘤药物的患者。通过混合效应逻辑回归和基于机器学习的 LightGBM 模型人工智能技术，对人口统计学、抗肿瘤药物、恶性肿瘤类型以及伴随药物与低钠血症（定义为血清钠浓度≤130 mmol/l）之间的关联进行了分析。在 2644 名患者中, 657 人 (24.8%) 至少发生过一次低钠血症。大约 80% 的低钠血症是由于肾脏消耗钠所致。通过混合效应逻辑回归和 LightGBM 模型得出的与低钠血症相关的变量是年龄较大、低蛋白血症和较高的估计肾小球滤过率。在抗肿瘤药物中，顺铂{比值比 [OR] 1.52 [95% 置信区间 (CI) 1.18-1.96]}、派姆单抗 [OR 1.42 (95% CI 1.02-1.97)] 和硼替佐米 [OR 3.04 (95% CI 1.96-) 4.71)]与低钠血症相关，这些变量也对 LightGBM 模型中预测的低钠血症有积极影响。低钠血症在恶性肿瘤患者中很常见。除了年龄较大和营养状况不佳之外，新型抗肿瘤药物，包括免疫检查点抑制剂和硼替佐米，应被视为低钠血症的危险因素。© 作者 2023。由牛津大学出版社代表 ERA 出版。

Hyponatremia is associated with worse outcomes among patients with malignancy. However, contemporary cohort data on epidemiology and risk factors are lacking.In this single-centre, retrospective cohort study, patients who received intravenous antineoplastic agents from 2018 to 2020 at Nagoya City University Hospital were enrolled. Associations of demographics, antineoplastic agents, types of malignancy and concomitant medications with hyponatremia, defined as serum sodium concentration ≤130 mmol/l, were analysed by mixed-effects logistic regression and the machine learning-based LightGBM model artificial intelligence technology.Among 2644 patients, 657 (24.8%) developed at least one episode of hyponatremia. Approximately 80% of hyponatremia was due to sodium wasting from the kidneys. Variables associated with hyponatremia both by mixed-effects logistic regression and the LightGBM model were older age, hypoalbuminemia and higher estimated glomerular filtration rate. Among antineoplastic agents, cisplatin {odds ratio [OR] 1.52 [95% confidence interval (CI) 1.18-1.96]}, pembrolizumab [OR 1.42 (95% CI 1.02-1.97)] and bortezomib [OR 3.04 (95% CI 1.96-4.71)] were associated with hyponatremia and these variables also had a positive impact on predicted hyponatremia in the LightGBM model.Hyponatremia was common among patients with malignancy. In addition to older age and poor nutritional status, novel antineoplastic agents, including immune checkpoint inhibitors and bortezomib, should be recognized as risk factors for hyponatremia.© The Author(s) 2023. Published by Oxford University Press on behalf of the ERA.