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Clinical aspects of symptomatic hyponatremia

Hyponatremia (HN) is a common condition, with a large number of etiologies and a complicated treatment. Although chronic HN has been shown to be a predictor of poor outcome, sodium-increasing treatments in chronic stable and asymptomatic HN have not proven to increase life expectancy. For symptomati...

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Autores principales: Weismann, Dirk, Schneider, Andreas, Höybye, Charlotte
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Bioscientifica Ltd 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5314806/
https://www.ncbi.nlm.nih.gov/pubmed/27609587
http://dx.doi.org/10.1530/EC-16-0046
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author Weismann, Dirk
Schneider, Andreas
Höybye, Charlotte
author_facet Weismann, Dirk
Schneider, Andreas
Höybye, Charlotte
author_sort Weismann, Dirk
collection PubMed
description Hyponatremia (HN) is a common condition, with a large number of etiologies and a complicated treatment. Although chronic HN has been shown to be a predictor of poor outcome, sodium-increasing treatments in chronic stable and asymptomatic HN have not proven to increase life expectancy. For symptomatic HN, in contrast, the necessity for urgent treatment has broadly been accepted to avoid the development of fatal cerebral edema. On the other hand, a too rapid increase of serum sodium in chronic HN may result in cerebral damage due to osmotic demyelinisation. Recently, administration of hypertonic saline bolus has been recommended as first-line treatment in patients with moderate-to-severe symptomatic HN. This approach is easy to memorize and holds the potential to greatly facilitate the initial treatment of symptomatic HN. First-line treatment of chronic HN is fluid restriction and if ineffective treatment with tolvaptan or in some patients other agents should be considered. A number of recommendations and guidelines have been published on HN. In the present review, the management of patients with HN in relation to everyday clinical practice is summarized with focus on the acute management.
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spelling pubmed-53148062017-02-27 Clinical aspects of symptomatic hyponatremia Weismann, Dirk Schneider, Andreas Höybye, Charlotte Endocr Connect Review Hyponatremia (HN) is a common condition, with a large number of etiologies and a complicated treatment. Although chronic HN has been shown to be a predictor of poor outcome, sodium-increasing treatments in chronic stable and asymptomatic HN have not proven to increase life expectancy. For symptomatic HN, in contrast, the necessity for urgent treatment has broadly been accepted to avoid the development of fatal cerebral edema. On the other hand, a too rapid increase of serum sodium in chronic HN may result in cerebral damage due to osmotic demyelinisation. Recently, administration of hypertonic saline bolus has been recommended as first-line treatment in patients with moderate-to-severe symptomatic HN. This approach is easy to memorize and holds the potential to greatly facilitate the initial treatment of symptomatic HN. First-line treatment of chronic HN is fluid restriction and if ineffective treatment with tolvaptan or in some patients other agents should be considered. A number of recommendations and guidelines have been published on HN. In the present review, the management of patients with HN in relation to everyday clinical practice is summarized with focus on the acute management. Bioscientifica Ltd 2016-10-07 /pmc/articles/PMC5314806/ /pubmed/27609587 http://dx.doi.org/10.1530/EC-16-0046 Text en © 2016 The authors http://creativecommons.org/licenses/by-nc/4.0/ This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Review
Weismann, Dirk
Schneider, Andreas
Höybye, Charlotte
Clinical aspects of symptomatic hyponatremia
title Clinical aspects of symptomatic hyponatremia
title_full Clinical aspects of symptomatic hyponatremia
title_fullStr Clinical aspects of symptomatic hyponatremia
title_full_unstemmed Clinical aspects of symptomatic hyponatremia
title_short Clinical aspects of symptomatic hyponatremia
title_sort clinical aspects of symptomatic hyponatremia
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5314806/
https://www.ncbi.nlm.nih.gov/pubmed/27609587
http://dx.doi.org/10.1530/EC-16-0046
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