Complications and management of hyponatremia

Department

Medicine

Document Type

Article

Publication Title

Current Opinion in Nephrology and Hypertension

Abstract

PURPOSE OF REVIEW: Hyponatremia causes significant morbidity, mortality, and disability. This review considers the literature of the past 18 months to improve understanding of these complications and to identify therapeutic strategies to prevent them. RECENT FINDINGS: Acute hyponatremia causes serious brain swelling that can lead to permanent disability or death. A 4-6 mEq/l increase in serum sodium is sufficient to reverse impending herniation. Brain swelling is minimal in chronic hyponatremia, and to avoid osmotic demyelination, correction should not exceed 8 mEq/l/day. In high-risk patients, correction should not exceed 4-6 mEq/l/day. Inadvertent overcorrection of hyponatremia is common and preventable by controlling unwanted urinary water losses with desmopressin. Even mild chronic hyponatremia is associated with increased mortality, attention deficit, gait instability, osteoporosis, and fractures, but it is not known if the correction of mild hyponatremia improves outcomes. SUMMARY: Controlled trials are needed to identify affordable treatments for hyponatremia that reduce the need for hospitalization, decrease hospital length of stay, and decrease morbidity. Such trials could also help answer the question of whether hyponatremia causes excess mortality or whether it is simply a marker for severe, lethal, underlying disease.

First Page

114

Last Page

9

DOI

10.1097/MNH.0000000000000200

Volume

25

Issue

2

Publication Date

3-1-2016

Medical Subject Headings

Animals; Brain Edema (etiology); Cognition Disorders (etiology); Deamino Arginine Vasopressin (therapeutic use); Fractures, Bone (etiology); Gait Disorders, Neurologic (etiology); Humans; Hypernatremia (chemically induced, prevention & control); Hyponatremia (blood, complications, mortality, therapy); Osteoporosis (etiology); Saline Solution, Hypertonic (administration & dosage, adverse effects); Sodium (blood); Sodium Chloride (administration & dosage, adverse effects)

PubMed ID

26735146

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