Treatment of Severe Hyponatremia

Department

Medicine

Document Type

Article

Publication Title

Clinical Journal Of The American Society Of Nephrology

Abstract

Patients with severe (serum sodium ≤120 mEq/L), symptomatic hyponatremia can develop life-threatening or fatal complications from cerebral edema if treatment is inadequate and permanent neurologic disability from osmotic demyelination if treatment is excessive. Unfortunately, as is true of all electrolyte disturbances, there are no randomized trials to guide the treatment of this challenging disorder. Rather, therapeutic decisions rest on physiologic principles, animal models, observational studies, and single-patient reports. European guidelines and recommendations of an American Expert panel have come to similar conclusions on how much correction of hyponatremia is enough and how much is too much, but there are important differences. We review the evidence supporting these recommendations, identifying areas that rest on relatively solid ground and highlighting areas in greatest need of additional data.

First Page

641

Last Page

649

DOI

10.2215/CJN.10440917

Volume

13

Issue

4

Publication Date

4-6-2018

Medical Subject Headings

Acute Disease; Brain Edema (etiology); Chronic Disease; Demyelinating Diseases (chemically induced); Hyponatremia (blood, complications, therapy); Practice Guidelines as Topic; Saline Solution (administration & dosage, adverse effects); Severity of Illness Index; Sodium (adverse effects, blood)

PubMed ID

29295830

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