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Hyponatremia

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43 papers 25 to 100 followers
By Isabel Acosta-Ochoa Nephrology senior staff. Valladolid. Spain
https://www.readbyqxmd.com/read/30071178/pharmacological-management-of-hyponatremia
#1
Theodosios Filippatos, Moses Elisaf, George Liamis
Hyponatremia is the most common electrolyte disorder with a prevalence of up to 30% in hospitalized patients. Furthermore, it is associated with increased morbidity and mortality. Areas covered: This review discusses the efficacy and side effects of the currently available treatment options for hyponatremia and the differences in the pharmacological approach between the European and USA guidelines. Additionally, the authors provide their expert perspectives on current treatment strategies and what they expect from this field in the future...
August 2, 2018: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/30067922/a-copeptin-based-approach-in-the-diagnosis-of-diabetes-insipidus
#2
Wiebke Fenske, Julie Refardt, Irina Chifu, Ingeborg Schnyder, Bettina Winzeler, Juliana Drummond, Antônio Ribeiro-Oliveira, Tilman Drescher, Stefan Bilz, Deborah R Vogt, Uwe Malzahn, Matthias Kroiss, Emanuel Christ, Christoph Henzen, Stefan Fischli, Anke Tönjes, Beat Mueller, Jochen Schopohl, Jörg Flitsch, Georg Brabant, Martin Fassnacht, Mirjam Christ-Crain
BACKGROUND: The indirect water-deprivation test is the current reference standard for the diagnosis of diabetes insipidus. However, it is technically cumbersome to administer, and the results are often inaccurate. The current study compared the indirect water-deprivation test with direct detection of plasma copeptin, a precursor-derived surrogate of arginine vasopressin. METHODS: From 2013 to 2017, we recruited 156 patients with hypotonic polyuria at 11 medical centers to undergo both water-deprivation and hypertonic saline infusion tests...
August 2, 2018: New England Journal of Medicine
https://www.readbyqxmd.com/read/30054781/continuous-versus-intermittent-administration-of-furosemide-in-acute-decompensated-heart-failure-a-systematic-review-and-meta-analysis
#3
REVIEW
Akira Kuriyama, Seigo Urushidani
Diuretic therapy is important in critically ill patients because fluid overload impairs organ function and increases mortality. Compared to intermittent administration, continuous infusion of loop diuretics is theoretically superior in terms of diuresis and electrolyte balance. However, the available evidence is susceptible to carryover diuretic effects and resistance in earlier crossover trials. Consequently, we conducted a systematic review and meta-analysis of parallel-group randomized controlled trials to compare these two strategies in adults with acute decompensated heart failure...
July 21, 2018: Heart Failure Reviews
https://www.readbyqxmd.com/read/30036896/-disturbances-of-sodium-homeostasis
#4
Florian Dresely
Sodium is the most important osmotically effective cation in the extracellular space and very important for the water balance of the organism. Disturbances in the sodium homeostasis are therefore usually closely associated with disturbances in the water balance. The most important organs involved in the regulation of the sodium homeostasis are the kidneys and the brain. Disturbances of sodium homeostasis are common electrolyte disturbances, which can cause serious complications, as well as their improper therapy...
July 2018: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/30041232/dysnatremia-in-renal-failure
#5
Taisuke Shimizu, Masaaki Terao, Hiroaki Hara, Takatsugu Iwashita, Tomonari Ogawa, Koichi Kanozawa, Hajime Hasegawa
Proximal salt reabsorption in the hypertrophied tubules in the early phase of chronic renal failure (CRF) would be diminished according to the inhibited expression of proximal salt-transporting molecules, which may be facilitated by the inhibition of Na-K-ATPase expression. Results from animal models suggest that patients with early-phase CRF would easily develop hyponatremia and, in contrast, patients showing developed CRF would be more likely to show dehydration or hypernatremia. Several large-scale studies of individuals with chronic kidney disease (CKD) revealed that hyponatremia is much more common than hypernatremia in patients with earlier stages of CKD...
2018: Contributions to Nephrology
https://www.readbyqxmd.com/read/29953167/interventions-for-chronic-non-hypovolaemic-hypotonic-hyponatraemia
#6
REVIEW
Evi V Nagler, Maria C Haller, Wim Van Biesen, Raymond Vanholder, Jonathan C Craig, Angela C Webster
BACKGROUND: Chronic (present > 48 hours) non-hypovolaemic hyponatraemia occurs frequently, can be caused by various conditions, and is associated with shorter survival and longer hospital stays. Many treatments, such as fluid restriction or vasopressin receptor antagonists can be used to improve the hyponatraemia, but whether that translates into improved patient-important outcomes is less certain. OBJECTIVES: This review aimed to 1) look at the benefits and harms of interventions for chronic non-hypovolaemic hypotonic hyponatraemia when compared with placebo, no treatment or head-to-head; and 2) determine if benefits and harms vary in absolute or relative terms dependent on the specific compound within a drug class, on the dosage used, or the underlying disorder causing the hyponatraemia...
June 28, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29880972/the-impact-of-albumin-use-on-resolution-of-hyponatremia-in-hospitalized-patients-with-cirrhosis
#7
Jasmohan S Bajaj, Puneeta Tandon, Jacqueline G O'Leary, Scott W Biggins, Florence Wong, Patrick S Kamath, Guadalupe Garcia-Tsao, Benedict Maliakkal, Jennifer C Lai, Michael Fallon, Paul Thuluvath, Hugo E Vargas, Ram M Subramanian, Leroy R Thacker, K Rajender Reddy
OBJECTIVES: Hyponatremia is associated with poor outcomes in cirrhosis independent of MELD. While intravenous albumin has been used in small series, its role in hyponatremia is unclear. The aim of this study is to determine the effect of albumin therapy on hyponatremia. METHODS: Hospitalized cirrhotic patients included in the NACSELD (North American Consortium for End-Stage Liver Disease) cohort with hyponatremia (Na <130mmol/L) were divided into those receiving intravenous albumin or not...
June 8, 2018: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/29871886/risk-factors-and-outcomes-of-rapid-correction-of-severe-hyponatremia
#8
Jason C George, Waleed Zafar, Ion Dan Bucaloiu, Alex R Chang
BACKGROUND AND OBJECTIVES: Rapid correction of severe hyponatremia can result in serious neurologic complications, including osmotic demyelination. Few data exist on incidence and risk factors of rapid correction or osmotic demyelination. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: In a retrospective cohort of 1490 patients admitted with serum sodium <120 mEq/L to seven hospitals in the Geisinger Health System from 2001 to 2017, we examined the incidence and risk factors of rapid correction and osmotic demyelination...
July 6, 2018: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29566068/low-serum-sodium-levels-at-hospital-admission-outcomes-among-2-3-million-hospitalized-patients
#9
COMPARATIVE STUDY
Saleem Al Mawed, V Shane Pankratz, Kelly Chong, Matthew Sandoval, Maria-Eleni Roumelioti, Mark Unruh
BACKGROUND: Hyponatremia is the most common electrolyte disorder among hospitalized patients. Controversies still exist over the relationship between hyponatremia and outcomes of hospitalized patients. METHODS: To analyze the association of low serum sodium levels at hospital admission with in-hospital mortality and patient disposition and to compare the distribution of the risk of death associated with hyponatremia across the lifespan of hospitalized patients, we conducted an observational study of 2...
2018: PloS One
https://www.readbyqxmd.com/read/29507848/-beer-potomania-a-syndrome-of-severe-hyponatremia-with-unique-pathophysiology-case-studies-and-literature-review
#10
Muhammad Uzair Lodhi, Tahira Sabeen Saleem, Aaron R Kuzel, Dawood Khan, Intekhab Askari Syed, Umar Rahim, Hafiz Imran Iqbal, Mustafa Rahim
Beer potomania, a unique syndrome of hyponatremia, was first reported in 1972. It is described as the excessive intake of alcohol, particularly beer, together with poor dietary solute intake that leads to fatigue, dizziness, and muscular weakness. The low solute content of beer, and suppressive effect of alcohol on proteolysis result in reduced solute delivery to the kidney. The presence of inadequate solute in the kidney eventually causes dilutional hyponatremia secondary to reduced clearance of excess fluid from the body...
December 29, 2017: Curēus
https://www.readbyqxmd.com/read/29417373/practical-issues-for-the-management-of-hyponatremia-in-oncology
#11
Rossana Berardi, Andrea Antonuzzo, Livio Blasi, Roberta Buosi, Vito Lorusso, Maria Rita Migliorino, Vincenzo Montesarchio, Nicoletta Zilembo, Roberto Sabbatini, Alessandro Peri
Hyponatremia is common in cancer patients and has a negative impact on outcomes and survival. Both the diagnosis and treatment of hyponatremia are challenging. Easy-to-use, practical guidelines are needed. The aim of this article is to discuss practical issues related to the diagnostic workup and management of hyponatremia, with particular attention to complex patients, such as those affected by neoplastic diseases. Admittedly, these patients may present several comorbidities, which may cause sodium alterations...
July 2018: Endocrine
https://www.readbyqxmd.com/read/29396621/progressive-kidney-disease-may-not-alter-the-association-of-hyponatremia-with-mortality
#12
Ladan Golestaneh, Joel Neugarten, Frederick Kaskel, Aileen P McGinn
BACKGROUND: Hyponatremia is a common electrolyte disorder and a prognostic marker for mortality. We hypothesize that in advanced chronic or acute kidney disease, hyponatremia is not independently associated with mortality because of the contribution of kidney failure to its pathophysiology. METHODS: Clinical Looking Glass, Montefiore's clinical database, was used to build a cohort of all patients hospitalized between January of 2009 and December of 2011. A chronic kidney disease (CKD) group and an acute kidney injury (AKI) group were defined based on GFR measurements during and before index hospitalization...
August 2018: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/29307961/clinical-profile-of-patients-admitted-with-hyponatremia-in-the-medical-intensive-care-unit
#13
Prakash Babaliche, Siddharth Madnani, Sajal Kamat
Background and Aims: Hyponatremia is the predominant electrolyte abnormality with an incidence rate of approximately 22%. It is the leading cause of morbidity and mortality with scarce data in Indian intensive care settings. The aim of this study is to evaluate the clinical features and etiology of hyponatremia in patients admitted to an Intensive Care Unit (ICU) of a tertiary care hospital. Materials and Methods: A 1-year prospective cross-sectional observational study was conducted, including 100 adult patients with moderate-to-severe hyponatremia admitted to the Medical ICU...
December 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29295830/treatment-of-severe-hyponatremia
#14
REVIEW
Richard H Sterns
Patients with severe (serum sodium ≤120 mEq/L), symptomatic hyponatremia can develop life-threatening or fatal complications from cerebral edema if treatment is inadequate and permanent neurologic disability from osmotic demyelination if treatment is excessive. Unfortunately, as is true of all electrolyte disturbances, there are no randomized trials to guide the treatment of this challenging disorder. Rather, therapeutic decisions rest on physiologic principles, animal models, observational studies, and single-patient reports...
April 6, 2018: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29200139/hyperkalemia-and-acute-kidney-injury-in-an-adolescent-thinking-outside-the-box
#15
Adam Szadkowski, Allison J Pollock, Awni M Al-Subu
Addison disease is a rare endocrine disorder, which typically presents with nonspecific symptoms including weight loss, fatigue, and nausea in conjunction with hyponatremia and hyperkalemia. This case demonstrates key diagnostic clues in evaluation of an adolescent who presented with severe hyperkalemia and acute kidney injury that was resistant to insulin, glucose, and sodium polystyrene sulfonate and was found to have primary adrenal insufficiency.
December 1, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29174200/group-2-adrenal-insufficiency-screening-methods-and-confirmation-of-diagnosis
#16
REVIEW
Philippe Chanson, Laurence Guignat, Bernard Goichot, Olivier Chabre, Dinane Samara Boustani, Rachel Reynaud, Dominique Simon, Antoine Tabarin, Damien Gruson, Yves Reznik, Marie-Laure Raffin Sanson
A diagnosis of adrenal insufficiency should be suspected in the presence of a number of non-specific symptoms (fatigue, anorexia, weight loss, hypotension, hyponatremia and hyperkalemia amongst adrenal causes of insufficiency). The diagnosis should be considered in case of pituitary disease or a state of shock. Treatment should be commenced immediately without waiting for confirmation from biochemical tests, which rely on cortisol level at 8am (expected to be low) and on ACTH level (expected to be high in the case of primary adrenal insufficiency)...
December 2017: Annales D'endocrinologie
https://www.readbyqxmd.com/read/29166900/association-between-borderline-dysnatremia-and-mortality-insight-into-a-new-data-mining-approach
#17
Yannick Girardeau, Anne-Sophie Jannot, Gilles Chatellier, Olivier Saint-Jean
BACKGROUND: Even small variations of serum sodium concentration may be associated with mortality. Our objective was to confirm the impact of borderline dysnatremia for patients admitted to hospital on in-hospital mortality using real life care data from our electronic health record (EHR) and a phenome-wide association analysis (PheWAS). METHODS: Retrospective observational study based on patient data admitted to Hôpital Européen George Pompidou, between 01/01/2008 and 31/06/2014; including 45,834 patients with serum sodium determinations on admission...
November 22, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/29078838/cerebral-salt-wasting-syndrome-diagnosis-by-urine-sodium-excretion
#18
Allen I Arieff, Ramin Gabbai, Ira D Goldfine
BACKGROUND: Cerebral salt-wasting syndrome (CSWS) was initially described over 60 years ago in hyponatremic patients with a cerebral lesion. However, the diagnostic criteria for CSWS have not been fully established. Thus, when hyponatremia is observed in patients with CSWS, they may be misdiagnosed as having the syndrome of inappropriate secretion of antidiuretic hormone (SIADH). Thus, it is critical to differentiate between these 2 conditions because their treatments are diametrically opposed...
October 2017: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/29031361/treatment-of-disorders-of-sodium-balance-in-chronic-kidney-disease
#19
REVIEW
David H Ellison
Extracellular fluid volume expansion is nearly universal in patients with CKD. Such volume expansion has features similar to the syndrome of heart failure with preserved ejection fraction, which not only leads to symptoms but can also lead to further organ damage. Unique treatment challenges are present in this patient population, including low glomerular filtration, which limits sodium chloride filtration, intrinsic tubule predisposition to sodium chloride retention, and proteinuria. In addition, pharmacokinetic considerations alter the disposition of diuretics in patients with CKD and nephrotic syndrome...
September 2017: Advances in Chronic Kidney Disease
https://www.readbyqxmd.com/read/28879182/vasopressin-receptor-antagonists-in-hyponatremia-uses-and-misuses
#20
REVIEW
Helbert Rondon-Berrios, Tomas Berl
Decreases in the concentration of sodium in plasma constitute hyponatremia, the commonest electrolyte disorder in clinical medicine. It is now well established that its presence conveys an increased mortality risk even when the decrement is mild. In addition, recent evidence suggests that chronic and apparently asymptomatic hyponatremia is associated with increased morbidity including neurocognitive deficits and bone fractures. Furthermore, hyponatremia is associated with higher health care-related expenses...
2017: Frontiers in Medicine
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