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adrogue hyponatremia

Maulin K Shah, Sreedhar Mandayam, Horacio J Adrogué
Osmotic demyelination unrelated to hyponatremia is rarely reported. We present a case of osmotic demyelination in a patient with hypernatremia in the absence of preceding hyponatremia and review previously reported cases of osmotic demyelination in nonhyponatremic patients. We conclude that a rapid increase in serum sodium concentration and plasma tonicity even in the absence of preceding hyponatremia may surpass the brain's capacity for adaptation to hypertonicity and lead to osmotic demyelination in predisposed individuals...
March 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Horacio J Adrogué
No abstract text is available yet for this article.
January 2017: Methodist DeBakey Cardiovascular Journal
Ramy Magdy Hanna, Wan-Ting Yang, Eduardo A Lopez, Joseph Nabil Riad, James Wilson
BACKGROUND: Improper correction of hyponatremia can cause severe complications, including osmotic demyelination syndrome (ODS). The Adrogué-Madias equation (AM), the Barsoum-Levine (BL) equation, the Electrolyte Free Water Clearance (EFWC) equation and the Nguyen-Kurtz (NK) equation are four derived equations based on the empirically derived Edelman equation for predicting sodium at a later time (Na2) from a known starting sodium (Na1), fluid/electrolyte composition and input and output volumes...
August 2016: Clinical Kidney Journal
Horacio J Adrogué, Nicolaos E Madias
No abstract text is available yet for this article.
November 2014: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Ataru Okumura, Kota Ishikawa, Risako Watanabe, Taku Tsunekawa, Chikako Asai, Atsushi Kiyota, Minemori Watanabe, Yutaka Oiso
Although various formulas predicting plasma sodium level ([Na]) are proposed for correction of hyponatremia, it seems that an anticipated [Na] frequently exceeds or falls below the measured [Na], especially in syndrome of inappropriate antidiuretic hormone secretion (SIADH). The causative factors of the fluctuation have never been investigated clearly. The aim of this study was to identify the determining factors for accurate prediction of [Na] by comparing data from previously proposed formulas and a novel osmotic compartment model (O-C model)...
July 2013: Translational Research: the Journal of Laboratory and Clinical Medicine
Horacio J Adrogué, Nicolaos E Madias
Treatment of hypotonic hyponatremia often challenges clinicians on many counts. Despite similar serum sodium concentrations, clinical manifestations can range from mild to life threatening. Some patients require active management, whereas others recover without intervention. Therapeutic measures frequently yield safe correction, yet the same measures can result in osmotic demyelination. To address this challenge, we present a practical approach to managing hyponatremia that centers on two elements: a diagnostic evaluation directed at the pathogenesis and putative causes of hyponatremia, the case-specific clinical and laboratory features, and the associated clinical risk; and a management plan tailored to the diagnostic findings that incorporates quantitative projections of fluid therapy and fluid losses on the patient's serum sodium, balances potential benefits and risks, and emphasizes vigilant monitoring...
July 2012: Journal of the American Society of Nephrology: JASN
Gagangeet Sandhu, Eduardo Zouain, Germaine Chan
Use of online formulas to treat hyponatremia is a common practice. We report here that while using the same goal of correction and type of infusate to treat a patient with hyponatremia, a large discrepancy in infusion rate is obtained from using the 2 commonly available online equations. When the therapy fluid is less concentrated saline (0.9%), Adrogue's formula poses the risk of large amount of volume being administered for only a small change in serum sodium concentration. This may be detrimental especially in patients with congestive heart failure...
October 2012: American Journal of Emergency Medicine
Luca Bettari, Mona Fiuzat, Gary M Felker, Christopher M O'Connor
Heart failure is one of the most common, costly, disabling and growing diseases (McMurray and Pfeffer in Lancet 365(9474):1877-1889, 2005). Hyponatremia, conventionally defined as a serum-sodium concentration equal or less than 135 mmol/l (American Heart Association in Heart disease and stroke statistics--2007 update. American Heart Association, Dallas, 2007; Stewart et al. in Eur J Heart Fail 4:361-371, 2002), is a common phenomenon in patients with heart failure, with an incidence of 20-25% (Krumholz et al...
January 2012: Heart Failure Reviews
D M Snell, C Bartley
We report a case of a young male with adrenal hypoplasia who presented following water intoxication with severe hyponatraemia and seizures. He required a period of intensive care and over the initial 24 h his serum sodium corrected at average of 0.9 mmol x l(-1) h(-1). He subsequently developed osmotic demyelination syndrome. Following supportive treatment he made a full recovery. Severe hyponatraemia carries a risk of cerebral oedema with a significant mortality, yet correcting it too rapidly can result in osmotic demyelination syndrome, again with potentially disastrous consequences...
January 2008: Anaesthesia
Tomas Berl
No abstract text is available yet for this article.
November 2007: Clinical Journal of the American Society of Nephrology: CJASN
Hashim K Mohmand, Dany Issa, Zubair Ahmad, Joseph D Cappuccio, Ruth W Kouides, Richard H Sterns
BACKGROUND AND OBJECTIVES: Data regarding dosage-response relationships for using hypertonic saline in treatment of hyponatremia are extremely limited. Objectives of this study were to assess adherence to previously published guidelines (limiting correction to <12 mEq/L per d and <18 mEq/L per 48 h) in treating hyponatremia with hypertonic saline and to determine the predictive accuracy of the Adrogué-Madias formula. DESIGN, SETTING, PARTICIPANTS & MEASUREMENTS: A retrospective review was conducted of all 62 adult, hyponatremic patients who were treated with hypertonic saline during 5 yr at a 528-bed, acute care, teaching hospital...
November 2007: Clinical Journal of the American Society of Nephrology: CJASN
George Liamis, Michalis Kalogirou, Vasilios Saugos, Moses Elisaf
BACKGROUND: Rapid correction of dysnatraemias is frequently associated with increased morbidity and mortality. Therefore, it is important to estimate the proper volume and type of infusate required to change the serum sodium concentration predictably. The aim of this study is to evaluate the utility or/and the accuracy of the Adrogue-Madias formula in managing patients with hyponatraemia and hypernatraemia. METHODS: Among the 317 patients who either on admission to our internal medicine clinic or during their hospitalization were found to have hyponatraemia or hypernatraemia, we studied 189 patients (59...
June 2006: Nephrology, Dialysis, Transplantation
Horacio J Adrogué
Dilutional hyponatremia is a commonly observed disorder in hospitalized patients. It represents an excess of water in relation to prevailing sodium stores and is most often associated with a high plasma level of arginine vasopressin, including that found in patients with the syndrome of inappropriate antidiuretic hormone secretion. Hyponatremia may be classified as either acute or chronic depending on the rate of decline of serum sodium concentration, and can lead to a wide range of deleterious changes involving almost all body systems...
May 2005: American Journal of Nephrology
Minhtri K Nguyen, Ira Kurtz
Rapid correction of the dysnatremias can result in significant patient morbidity and mortality. To avoid overly rapid correction of the dysnatremias, the sodium deficit equation, water deficit equation, and Adrogue-Madias equation are frequently utilized to predict the change in plasma sodium concentration (Delta[Na+]p) following a therapeutic maneuver. However, there are significant limitations inherent in these equations. Specifically, the sodium deficit equation assumes that total body water (TBW) remains unchanged...
June 2003: Clinical and Experimental Nephrology
H J Adrogué, N E Madias
No abstract text is available yet for this article.
May 25, 2000: New England Journal of Medicine
H J Adrogué, N E Madias
OBJECTIVE: The goal of the present study was to develop a novel approach that facilitates the prescription of fluid therapy in patients with abnormal serum sodium concentration. METHODOLOGY AND RESULTS: The novel approach is based on a simple equation, derived from established principles on the distribution of sodium in body fluids, that estimates the impact of a unit dose, i.e., 1 l of any infusate on the patient's serum sodium concentration. In accordance with the equation, the expected change in the patient's serum sodium concentration in response to 1 l of any infusate (delta[Na+]s) is obtained by subtracting the sodium concentration of the patient's serum from the sodium concentration of the infusate, each expressed in mEq/l, and dividing the result by the patient's estimated total body water expressed in liters (adding 1 l to account for the volume of the infusate)...
March 1997: Intensive Care Medicine
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