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Hyponatremia

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37 papers 25 to 100 followers
By Isabel Acosta-Ochoa Nephrology senior staff. Valladolid. Spain
https://www.readbyqxmd.com/read/29880972/the-impact-of-albumin-use-on-resolution-of-hyponatremia-in-hospitalized-patients-with-cirrhosis
#1
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
#2
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...
June 5, 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
#3
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
#4
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
#5
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
#6
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...
February 2, 2018: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/29307961/clinical-profile-of-patients-admitted-with-hyponatremia-in-the-medical-intensive-care-unit
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
https://www.readbyqxmd.com/read/28783044/phenotypic-and-pharmacogenetic-evaluation-of-patients-with-thiazide-induced-hyponatremia
#15
James S Ware, Louise V Wain, Sarath K Channavajjhala, Victoria E Jackson, Elizabeth Edwards, Run Lu, Keith Siew, Wenjing Jia, Nick Shrine, Sue Kinnear, Mahli Jalland, Amanda P Henry, Jenny Clayton, Kevin M O'Shaughnessy, Martin D Tobin, Victor L Schuster, Stuart Cook, Ian P Hall, Mark Glover
Thiazide diuretics are among the most widely used treatments for hypertension, but thiazide-induced hyponatremia (TIH), a clinically significant adverse effect, is poorly understood. Here, we have studied the phenotypic and genetic characteristics of patients hospitalized with TIH. In a cohort of 109 TIH patients, those with severe TIH displayed an extended phenotype of intravascular volume expansion, increased free water reabsorption, urinary prostaglandin E2 excretion, and reduced excretion of serum chloride, magnesium, zinc, and antidiuretic hormone...
September 1, 2017: Journal of Clinical Investigation
https://www.readbyqxmd.com/read/28697950/sodium-levels-on-admission-are-associated-with-mortality-risk-in-hospitalized-patients
#16
Amit Akirov, Talia Diker-Cohen, Tali Steinmetz, Oren Amitai, Ilan Shimon
AIMS: Abnormal sodium values are common among hospitalized patients. We aimed to investigate the association of admission sodium values and mortality. METHODS: Historical prospectively data of adult patients hospitalized to medical wards between January 2011 and December 2013. Admission sodium values were classified to five categories: severe hyponatremia (<125mEq/L), mild hyponatremia (125-135mEq/L), normal sodium values (135-145mEq/L), mild hypernatremia (145-150mEq/L) and severe hypernatremia (>150mEq/L)...
December 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28619670/hyponatraemia-diagnosis-and-treatment-clinical-practice-guidelines
#17
Goce Spasovski, Raymond Vanholder, Bruno Allolio, Djillali Annane, Steve Ball, Daniel Bichet, Guy Decaux, Wiebke Fenske, Ewout J Hoorn, Carole Ichai, Michael Joannidis, Alain Soupart, Robert Zietse, Maria Haller, Sabine van der Veer, Wim van Biesen, Evi Nagler, Liliana Gonzalez-Espinoza, Alberto Ortiz
Hyponatremia, defined as a serum sodium concentration <135mmol/l, is the most common water-electrolyte imbalance encountered in clinical practice. It can lead to a wide spectrum of clinical symptoms, from mild to severe or even life threatening, and is associated with increased mortality, morbidity and length of hospital stay. Despite this, the management of hyponatremia patients remains problematic. The prevalence of hyponatremia in a wide variety of conditions and the fact that hyponatremia is managed by clinicians with a broad variety of backgrounds have fostered diverse institution- and specialty-based approaches to diagnosis and treatment...
July 2017: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
https://www.readbyqxmd.com/read/28551002/development-of-a-computer-interpretable-clinical-guideline-model-for-decision-support-in-the-differential-diagnosis-of-hyponatremia
#18
Arturo González-Ferrer, M Ángel Valcárcel, Martín Cuesta, Joan Cháfer, Isabelle Runkle
INTRODUCTION: Hyponatremia is the most common type of electrolyte imbalance, occurring when serum sodium is below threshold levels, typically 135mmol/L. Electrolyte balance has been identified as one of the most challenging subjects for medical students, but also as one of the most relevant areas to learn about according to physicians and researchers. We present a computer-interpretable guideline (CIG) model that will be used for medical training to learn how to improve the diagnosis of hyponatremia applying an expert consensus document (ECDs)...
July 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/28504980/hyperchloremia-is-associated-with-acute-kidney-injury-in-patients-with-subarachnoid-hemorrhage
#19
Ofer Sadan, Kai Singbartl, Prem A Kandiah, Kathleen S Martin, Owen B Samuels
OBJECTIVE: To assess the prevalence of acute kidney injury in patients with subarachnoid hemorrhage patients. DESIGN: Retrospective analysis of all subarachnoid hemorrhage admissions. SETTINGS: Neurocritical care unit. PATIENTS: All patients with a diagnosis of subarachnoid hemorrhage between 2009 and 2014. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Of 1,267 patients included in this cohort, 16...
August 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28316939/application-of-established-pathophysiologic-processes-brings-greater-clarity-to-diagnosis-and-treatment-of-hyponatremia
#20
EDITORIAL
John K Maesaka, Louis J Imbriano, Nobuyuki Miyawaki
Hyponatremia, serum sodium < 135 mEq/L, is the most common electrolyte abnormality and is in a state of flux. Hyponatremic patients are symptomatic and should be treated but our inability to consistently determine the causes of hyponatremia has hampered the delivery of appropriate therapy. This is especially applicable to differentiating syndrome of inappropriate antidiuresis (SIAD) from cerebral salt wasting (CSW) or more appropriately, renal salt wasting (RSW), because of divergent therapeutic goals, to water-restrict in SIAD and administer salt and water in RSW...
March 6, 2017: World Journal of Nephrology
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