Hypertonic Saline for Hyponatremia: Meeting Goals and Avoiding Harm

Department

Medicine

Document Type

Article

Publication Title

American Journal of Kidney Diseases

Abstract

Hypertonic saline has been used for the treatment of hyponatremia for nearly a century. There is now general consensus that hypertonic saline should be used in patients with hyponatremia associated with moderate or severe symptoms to prevent neurological complications. However, much less agreement exists among experts regarding other aspects of its use. Should hypertonic saline be administered as a bolus injection or continuous infusion? What is the appropriate dose? Is a central venous line necessary? Should desmopressin be used concomitantly and for how long? This article considers these important questions, briefly explores the historical origins of hypertonic saline use for hyponatremia, and reviews recent evidence behind its indications, dosing, administration modality and route, combined use with desmopressin to prevent rapid correction of serum sodium, and other considerations such as the need and degree for fluid restriction. The authors conclude by offering some practical recommendations for the use of hypertonic saline.

First Page

890

Last Page

896

DOI

10.1053/j.ajkd.2021.07.020

Volume

79

Issue

6

Publication Date

6-2022

PubMed ID

34508830

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