Overcorrection of hyponatremia is a medical emergency. Excessive correction usually results from the unexpected emergence of a water diuresis after resolution of the cause of water retention. The concurrent administration of desmopressin and 5% dextrose in water can be given to cautiously re-lower the serum sodium concentration when therapeutic limits have been exceeded. Nephrologists should be equally aggressive in correcting hyponatremia and in un-correcting it when their patients get too much of a good thing.
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http://dx.doi.org/10.1038/ki.2009.251 | DOI Listing |
Endocr Pract
December 2024
Department of Endocrinology, King's College Hospital NHS Foundation Trust, London, United Kingdom. Electronic address:
Objectives: The recommended dose of tolvaptan for hyponatraemia secondary to SIADH is 15mg. We evaluated the efficacy of an initial 7.5mg dose and determined the frequency where sodium (Na+) correction exceeded safe limits, defined as an increment of ≥10 mmol/L, within the initial 8 or 24 hours of administration.
View Article and Find Full Text PDFCureus
November 2024
Anaesthesia, Dow Health Sciences Karachi, Karachi, PAK.
The syndrome of inappropriate antidiuretic hormone secretion (SIADH) is a frequent cause of hyponatremia that presents substantial management challenges in clinical settings. Despite a range of treatment options, including fluid restriction, demeclocycline, and vasopressin antagonists, urea remains underutilized, particularly in North America, despite its well-documented efficacy, safety, and cost-effectiveness. Urea corrects hyponatremia by promoting osmotic diuresis without causing significant fluid shifts, making it an ideal treatment for both acute and chronic SIADH.
View Article and Find Full Text PDFRev Clin Esp (Barc)
December 2024
Unidad de Medicina Oral, Cirugía Oral e Implantología, Facultad de Medicina y Odontología, Universidad de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain.
Background And Objectives: Hyponatraemia is common in elderly and hospitalised patients, often caused by the syndrome of inappropriate antidiuretic hormone secretion (SIADH). This study evaluates the efficacy and safety of tolvaptan and urea in patients with hyponatraemia and SIADH.
Materials And Methods: An observational cohort study was conducted on 198 patients with SIADH and hyponatraemia (Na+ <135 mmol/L) at the Complejo Hospitalario Universitario de Pontevedra from January 2015 to May 2022.
Cureus
September 2024
Internal Medicine/Malignant Hematology, Westchester Medical Center, Valhalla, USA.
Medicina (Kaunas)
August 2024
General Intensive Care Unit, University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton SO16 6YD, UK.
Hyponatraemia is a common electrolyte disorder. For patients with severe hyponatraemia, intensive care unit (ICU) admission may be required. This will enable close monitoring and allow safe management of sodium levels effectively.
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