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Treatment of hyponatremia

Treatment of hyponatremia Richard H. Sterns, John Kevin Hix and Stephen Silver Nephrology Division, Rochester General Hospital, Purpose of review University of Rochester School of Medicine and We review literature from the past 18 months on the treatment of hyponatremia. Therapy Dentistry, Rochester, New York, USA must address both the consequences of the untreated electrolyte disturbance Correspondence to Richard H. Sterns, MD, 1425 (including fatal cerebral edema due to acute water intoxication) and the complications of Portland Avenue, Rochester, NY 14621, USA Tel: +1 585 922 4242; fax: +1 585 922 4440; excessive therapy (the osmotic demyelination syndrome). e-mail: Richard.Sterns@rochestergeneral.org Recent findings Current Opinion in Nephrology and Correction of hyponatremia by 4 – 6 mEq/l within 6 h, with bolus infusions of 3% saline if Hypertension 2010, 19:493–498 necessary, is sufficient to manage the most severe manifestations of hyponatremia. Planning therapy to achieve a 6 mEq/l daily increase in the serum sodium concentration can avoid iatrogenic brain damage by staying well clear of correction rates that are harmful. Conservative correction goals are wise because inadvertent overcorrection is common. Administration of desmopressin to halt a water diuresis can help prevent overcorrection; if overcorrection occurs, therapeutic relowering of the serum sodium concentration is supported http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Current Opinion in Nephrology & Hypertension Wolters Kluwer Health

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References (135)

ISSN
1062-4821
eISSN
1473-6543
DOI
10.1097/MNH.0b013e32833bfa64
pmid
20539224
Publisher site
See Article on Publisher Site

Abstract

Richard H. Sterns, John Kevin Hix and Stephen Silver Nephrology Division, Rochester General Hospital, Purpose of review University of Rochester School of Medicine and We review literature from the past 18 months on the treatment of hyponatremia. Therapy Dentistry, Rochester, New York, USA must address both the consequences of the untreated electrolyte disturbance Correspondence to Richard H. Sterns, MD, 1425 (including fatal cerebral edema due to acute water intoxication) and the complications of Portland Avenue, Rochester, NY 14621, USA Tel: +1 585 922 4242; fax: +1 585 922 4440; excessive therapy (the osmotic demyelination syndrome). e-mail: Richard.Sterns@rochestergeneral.org Recent findings Current Opinion in Nephrology and Correction of hyponatremia by 4 – 6 mEq/l within 6 h, with bolus infusions of 3% saline if Hypertension 2010, 19:493–498 necessary, is sufficient to manage the most severe manifestations of hyponatremia. Planning therapy to achieve a 6 mEq/l daily increase in the serum sodium concentration can avoid iatrogenic brain damage by staying well clear of correction rates that are harmful. Conservative correction goals are wise because inadvertent overcorrection is common. Administration of desmopressin to halt a water diuresis can help prevent overcorrection; if overcorrection occurs, therapeutic relowering of the serum sodium concentration is supported

Journal

Current Opinion in Nephrology & HypertensionWolters Kluwer Health

Published: Sep 1, 2010

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