Deprecated: Implicit conversion from float 235.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 235.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Kidney+Int 2015 ; 88 (1): 167-77 Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Current treatment practice and outcomes Report of the hyponatremia registry #MMPMID25671764
Greenberg A; Verbalis JG; Amin AN; Burst VR; Chiodo III JA; Chiong JR; Dasta JF; Friend KE; Hauptman PJ; Peri A; Sigal SH
Kidney Int 2015[Jul]; 88 (1): 167-77 PMID25671764show ga
Current management practices for hyponatremia (HN) are incompletely understood. The HN Registry has recorded diagnostic measures, utilization, efficacy, and outcomes of therapy for eu- or hypervolemic HN. To better understand current practices, we analyzed data from 3087 adjudicated adult patients in the registry with serum sodium concentration of 130?mEq/l or less from 225 sites in the United States and European Union. Common initial monotherapy treatments were fluid restriction (35%), administration of isotonic (15%) or hypertonic saline (2%), and tolvaptan (5%); 17% received no active agent. Median (interquartile range) mEq/l serum sodium increases during the first day were as follows: no treatment, 1.0 (0.0?4.0); fluid restriction, 2.0 (0.0?4.0); isotonic saline, 3.0 (0.0?5.0); hypertonic saline, 5.0 (1.0?9.0); and tolvaptan, 4.0 (2.0?9.0). Adjusting for initial serum sodium concentration with logistic regression, the relative likelihoods for correction by 5?mEq/l or more (referent, fluid restriction) were 1.60 for hypertonic saline and 2.55 for tolvaptan. At discharge, serum sodium concentration was under 135?mEq/l in 78% of patients and 130?mEq/l or less in 49%. Overly rapid correction occurred in 7.9%. Thus, initial HN treatment often uses maneuvers of limited efficacy. Despite an association with poor outcomes and availability of effective therapy, most patients with HN are discharged from hospital still hyponatremic. Studies to assess short- and long-term benefits of correction of HN with effective therapies are needed.