Diagnosis, evaluation, and treatment of hyponatremia: Expert panel recommendations

Joseph G. Verbalis, Steven Goldsmith, Arthur Greenberg, Cynthia Korzelius, Robert W. Schrier, Richard H. Sterns, Christopher J. Thompson

Research output: Contribution to journalReview articlepeer-review

539 Scopus citations

Abstract

Hyponatremia is a serious, but often overlooked, electrolyte imbalance that has been independently associated with a wide range of deleterious changes involving many different body systems. Untreated acute hyponatremia can cause substantial morbidity and mortality as a result of osmotically induced cerebral edema, and excessively rapid correction of chronic hyponatremia can cause severe neurologic impairment and death as a result of osmotic demyelination. The diverse etiologies and comorbidities associated with hyponatremia pose substantial challenges in managing this disorder. In 2007, a panel of experts in hyponatremia convened to develop the Hyponatremia Treatment Guidelines 2007: Expert Panel Recommendations that defined strategies for clinicians caring for patients with hyponatremia. In the 6 years since the publication of that document, the field has seen several notable developments, including new evidence on morbidities and complications associated with hyponatremia, the importance of treating mild to moderate hyponatremia, and the efficacy and safety of vasopressin receptor antagonist therapy for hyponatremic patients. Therefore, additional guidance was deemed necessary and a panel of hyponatremia experts (which included all of the original panel members) was convened to update the previous recommendations for optimal current management of this disorder. The updated expert panel recommendations in this document represent recommended approaches for multiple etiologies of hyponatremia that are based on both consensus opinions of experts in hyponatremia and the most recent published data in this field.

Original languageEnglish (US)
Pages (from-to)S1-S42
JournalAmerican Journal of Medicine
Volume126
Issue number10 SUPPL.1
DOIs
StatePublished - Oct 2013

Bibliographical note

Funding Information:
Funding: This supplement is based, in part, on a closed roundtable meeting that was held in October 2012 in New York City and was jointly sponsored by the Tufts University School of Medicine Office of Continuing Education and In 2 MedEd, LLC , through an unrestricted educational grant from Otsuka America Pharmaceutical, Inc.

Funding Information:
Conflict of Interest: Steven Goldsmith, MD has received grant support and non-CME (Continuing Medical Education)-related fees from Otsuka America Pharmaceutical, Inc . Arthur Greenberg, MD has received grant support and non-CME-related fees from Otsuka America Pharmaceutical, Inc., and Cornerstone Therapeutics . Cynthia Korzelius, MD has no potential conflicts of interest to disclose. Robert Schrier, MD has served as a consultant for Otsuka America Pharmaceutical, Inc., and Janssen Pharmaceutical. Richard Sterns, MD has no potential conflicts of interest to disclose. Joseph Verbalis, MD has received grant support from Otsuka America Pharmaceutical, Inc , as well as non-CME-related fees from Otsuka America Pharmaceutical, Inc., Cardiokine, and Cornerstone Therapeutics . Christopher Thompson, MD has served as a consultant for Otsuka European Pharmaceuticals.

Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.

Keywords

  • Antidiuretic hormone
  • Aquaretics
  • Hypo-osmolality
  • Natriuresis
  • Syndrome of inappropriate antidiuretic hormone secretion
  • Vasopressin
  • Volume regulation

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