Diagnosis and management of hyponatraemia in hospitalised patients

International Journal of Clinical Practice

Volumn 63, Issue 10, 2009, Pages 1494-1508

  Reddy, P ^a   Mooradian, A D ^a  

^a UNIVERSITY OF FLORIDA COLLEGE OF MEDICINE   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ALDOSTERONE ANTAGONIST; AMFEBUTAMONE; AMILORIDE PLUS HYDROCHLOROTHIAZIDE; ANTIBIOTIC AGENT; BRAIN NATRIURETIC PEPTIDE; CONIVAPTAN; DEMECLOCYCLINE; DESMOPRESSIN; DIPEPTIDYL CARBOXYPEPTIDASE INHIBITOR; DIURETIC AGENT; DULOXETINE; FLUDROCORTISONE ACETATE; GLUCOCORTICOID; GLYCINE; HALOPERIDOL; HYPOTONIC SOLUTION; LOOP DIURETIC AGENT; MANNITOL; MONOAMINE OXIDASE INHIBITOR; PHENOTHIAZINE DERIVATIVE; SEROTONIN UPTAKE INHIBITOR; SODIUM; SODIUM CHLORIDE; SORBITOL; THIAZIDE DIURETIC AGENT; TOLVAPTAN; TRICYCLIC ANTIDEPRESSANT AGENT; UNINDEXED DRUG; VASOPRESSIN; VASOPRESSIN ANTAGONIST; VASOPRESSIN RECEPTOR ANTAGONIST; ELECTROLYTE;

BODY WATER; BRAIN EDEMA; CEREBRAL SALT WASTING; CLINICAL FEATURE; CONTINUOUS INFUSION; DEMYELINATION; DISEASE SEVERITY; FLUID BALANCE; HEART FAILURE; HOSPITAL PATIENT; HUMAN; HYPERGLYCEMIA; HYPERVOLEMIA; HYPONATREMIA; HYPOVOLEMIA; HYPOVOLEMIC HYPONATREMIA; HYPOVOLEMIC HYPOTONIC HYPONATREMIA; INAPPROPRIATE VASOPRESSIN SECRETION; LIVER CIRRHOSIS; LOADING DRUG DOSE; LOW DRUG DOSE; PATHOPHYSIOLOGY; PLASMA OSMOLALITY; PRIORITY JOURNAL; REVIEW; SODIUM URINE LEVEL; SYMPTOM; WATER DEPRIVATION; ELECTROLYTE BALANCE; FLUID THERAPY; HOSPITALIZATION; INAPPROPRIATE ADH SYNDROME; OSMOLARITY;

ELECTROLYTES; FLUID THERAPY; HOSPITALIZATION; HUMANS; HYPONATREMIA; INAPPROPRIATE ADH SYNDROME; OSMOLAR CONCENTRATION; WATER-ELECTROLYTE BALANCE;

EID: 70349232731     PISSN: 13685031     EISSN: 17421241     Source Type: Journal    
DOI: 10.1111/j.1742-1241.2009.02103.x     Document Type: Review

References (109)

1. Anderson RJ, Chung HM, Kluge R, Schrier RW. Hyponatremia: a prospective analysis of its epidemiology and the pathogenetic role of vasopressin. Ann Intern Med 1985 102 : 164 168.
2. Callahan MA, Do HT, Caplan DW, Yoon-Flannery K. Economic impact of hyponatremia in hospitalized patients: a retrospective cohort study. Postgrad Med 2009 121 : 186 191.
3. Adrogue HJ, Madias NE. Hyponatremia. N Engl J Med 2000 342 : 1581 1589.
4. Sterns R. Sodium and water balance disorders. Neph SAP 2006 5 : 35 50.
5. Rose BD, Post TW. Clinical Physiology of Acid-Base and Electrolyte Disorders, 5th edn. New York : McGraw-Hill, 2001 : 607 608.
6. Rose BD, Post TW. Clinical Physiology of Acid-Base and Electrolyte Disorders, 5th edn. New York : McGraw-Hill, 2001 : 247 248.
7. Hoffman RS, Smilkstein MJ, Howland MA, Goldfrank LR. Osmole gaps revisited: normal values and limitations. J Toxicol Clin Toxicol 1993 31 : 81 93.
8. Purssell RA, Lynd LD, Koga Y. The use of the osmole gap as a screening test for the presence of exogenous substances. Toxicol Rev 2004 23 : 189 202.
9. Adrogue HJ, Madias NE. Sodium and potassium in the pathogenesis of hypertension. N Engl J Med 2007 356 : 1966 1978.
10. Greger R. Physiology of renal sodium transport. Am J Med Sci 2000 319 : 51 62.
11. Skott O, Jensen BL. Cellular and intrarenal control of renin secretion. Clin Sci (Lond) 1993 84 : 1 10.
12. Peach M. Renin-angiotensin system: biochemistry and mechanisms of action. Physiol Rev 1977 57 : 313 370.
13. Millar J, Leckie B, Semple P. Different responses of active and inactive plasma renin to various stimuli. Clin Sci Mol Med 1978 55 : 155s 7s.
14. Reid I. The renin-angiotensin system and body function. Arch Intern Med 1985 145 : 1475 1479.
15. Agre P. Aquaporin water channels in kidney. J Am Soc Nephrol 2000 11 : 764 777.
16. Sagnella GA, Markandu ND, Buckley MG. Hormonal responses to gradual changes in dietary sodium intake in humans. Am J Physiol 1989 256 : R1171 5.
17. Renneboog B, Musch W, Vandemergel X, Manto MU, Decaux G. Mild chronic hyponatremia is associated with falls, unsteadiness, and attention deficits. Am J Med 2006 119 : e1 8.
18. Cronin RE. Psychogenic polydipsia with hyponatremia: report of eleven cases. Am J Kidney Dis 1987 9 : 410 416.
19. Fraser CL, Arieff AI. Epidemiology, pathophysiology, and management of hyponatremic encephalopathy. Am J Med 1997 102 : 67 77.
20. Lien YH, Shapiro UI, Chan L. Study of brain electrolytes and organic osmolytes during correction of chronic hyponatremia. Implication for the pathogenesis of central pontine myelinolysis. J Clin Invest 1991 88 : 303 309.
21. Oya S, Tsutsumi K, Ueki K, Kirino T. Reinduction of hyponatremia to treat central pontine myelinolysis. Neurology 2001 57 : 1931 1932.
22. Sterns RH, Cappuccio JD, Silver SM, Cohen EP. Neurologic sequelae after treatment of severe hyponatremia, a multicenter perspective. J Am Soc Nephrol 1994 4 : 1522 1530.
23. Arieff AI. Influence of hypoxia and sex on hyponatremic encephalopathy. Am J Med 2006 119 (Suppl. 1 S59 64.
24. Bibl D, Lampl C, Gabriel C. Treatment of central pontine myelinolysis with therapeutic plasmapheresis. Lancet 1999 353 : 1155.
25. Grimaldi D, Cavalleri F, Vallone S. Plasmapheresis improves the outcome of central pontine myelinolysis. J Neurol 2005 252 : 734.
26. Narins RG. Diagnostic strategies in disorders of fluid, electrolyte and acid-base homeostasis. Am J Med 1982 72 : 496 520.
27. Issa MM, Young MR, Bullock AR. Dilutional hyponatremia of TURP syndrome: a historical event in the 21st century. Urology 2004 64 : 298 301.
28. Gonzalez R, Brensilver JM, Rovinsky JJ. Posthysteroscopic hyponatremia. Am J Kidney Dis 1994 23 : 735 738.
29. Bernstein GT, Loughlin KR, Gittes RF. The physiologic basis of the TUR syndrome. J Surg Res 1989 46 : 135 141.
30. Jensen V. The TURP syndrome. Can J Anaesth 1991 38 : 90 7.
31. Agarwal R, Emmett M. The post-transurethral resection of prostate syndrome: therapeutic proposals. Am J Kidney Dis 1994 24 : 108 111.
32. Campbell HT, Fincher ME, Sklar AH. Severe hyponatremia without severe hypoosmolality following transurethral resection of the prostate (TURP) in end-stage renal disease. Am J Kidney Dis 1988 12 : 152 155.
33. Rose BD, Post TW. Clinical Physiology of Acid-Base and Electrolyte Disorders, 5th edn. New York : McGraw-Hill, 2001 : 712 713.
34. Turchin A, Seifter JL, Seely EW. Clinical problem-solving. Mind the gap. N Engl J Med 2003 349 : 1465 1469.
35. Steinberger BA, Ford SM, Coleman TA. Intravenous immunoglobulin therapy results in post-infusional hyperproteinemia, increased plasma viscosity, and pseudohyponatremia. Am J Hematol 2003 73 : 97 100.
36. Weisberg LS. Pseudohyponatremia: a reappraisal. Am J Med 1989 86 : 315 318.
37. Maas AHJ, Siggaard-Andersen O, Weisberg HF, Zijlstra WG. Ion-selective electrodes for sodium and potassium: a new problem of what is measured and what should be reported. Clin Chem 1985 31 : 482 485.
38. Hillier TA, Abbott RD, Barrett EJ. Hyponatremia: evaluating the correction factor for hyperglycemia. Am J Med 1999 106 : 399 403.
39. Ellison DH. Clinical practice. The syndrome of inappropriate antidiuresis. N Engl J Med 2007 356 : 2064 2072.
40. Perianayagam A, Sterns RH, Silver SM. DDAVP is effective in preventing and reversing inadvertent overcorrection of hyponatremia. Clin J Am Soc Nephrol 2008 3 : 331 336.
41. Wierzbicki AS, Ball SG, Singh NK. Profound hyponatraemia following an idiosyncratic reaction to diuretics. Int J Clin Pract 1998 52 : 278 279.
42. Fadel S, Karmali R, Cogan E. Safety of furosemide administration in an elderly woman recovered from thiazide-induced hyponatremia. Eur J Intern Med 2009 20 : 30 4.
43. Zietse R, Zoutendijk R, Hoorn EJ. Fluid, electrolyte and acid-base disorders associated with antibiotic therapy. Nat Rev Nephrol 2009 5 : 193 202.
44. Chow KM, Kwan BC, Szeto CC. Clinical studies of thiazide-induced hyponatremia. J Natl Med Assoc 2004 96 : 1305 1308.
45. Sonnenblick M, Friedlander Y, Rosin AJ. Diuretic induced severe hyponatremia. Review and analysis of 129 reported patients. Chest 1993 103 : 601 606.
46. Clark BA, Shannon RP, Rosa RM, Epstein FH. Increased susceptibility to thiazide-induced hyponatremia in the elderly. J Am Soc Nephrol 1994 5 : 1106 1111.
47. Friedman E, Shadel M, Halkin H, Farfel Z. Thiazide-induced hyponatremia. Reproducibility by single dose challenge and an analysis of pathogenesis. Ann Intern Med 1989 110 : 24 30.
48. Szatalowicz VL, Miller PD, Lacher JW. Comparative effect of diuretics on renal water excretion in hyponatremic oedematous disorders. Clin Sci 1982 62 : 235 238.
49. Fichman MP, Vorherr H, Kleeman CR, Tefler N. Diuretic induced hyponatremia. Ann Intern Med 1971 75 : 853 863.
50. Marples D, Frokiaer J, Dorup J. Hypokalemia-induced downregulation of aquaporin-2 water channel expression in rat kidney medulla and cortex. J Clin Invest 1996 97 : 1960 1968.
51. Palmer BF. Hyponatremia in patients with central nervous system disease: SIADH versus CSW. Trends Endocrinol Metab 2003 14 : 182 187.
52. Berendes E, Walter M, Cullen P. Secretion of brain natriuretic peptide in patients with aneurysmal subarachnoid hemorrhage. Lancet 1997 349 : 245 249.
53. Zogheri A. Hyponatremia and pituitary adenoma: think twice about the etiopathogenesis. J Endocrinol Invest 2006 29 : 750 753.
54. Taplin CE, Cowell CT, Silink M, Ambler GR. Fludrocortisone therapy in cerebral salt wasting. Pediatrics 2006 118 : e1904 8.
55. Al-Mufti H, Arieff AI. Hyponatremia due to cerebral salt-wasting syndrome. Combined cerebral and distal tubular lesion. Am J Med 1984 77 : 740 746.
56. Benedict CR, Johnstone DE, Weiner DH, for the SOLVD Investigators. Relation of neurohumoral activation to clinical variables and degree of ventricular dysfunction: a report from the registry of Studies of Left Ventricular Dysfunction. J Am Coll Cardiol 1994 23 : 1410 1420.
57. Gheorghiade M, Abraham WT, Albert NM. Relationship between admission plasma sodium concentration and clinical outcomes in patients hospitalized for heart failure: an analysis from the OPTIMIZE-HF registry. Eur Heart J 2007 28 : 980 988.
58. Goldberg A, Hammerman H, Petcherski S. Hyponatremia and long-term mortality in survivors of acute ST-elevation myocardial infarction. Arch Intern Med 2006 166 : 781 786.
59. Lee WH, Packer M. Prognostic importance of plasma sodium concentration and its modification by converting-enzyme inhibition in patients with severe congestive heart failure. Circulation 1986 73 : 257 267.
60. Dzau VJ, Hollenberg NK. Renal response to captopril in severe heart failure: role of furosemide in natriuresis and reversal of hyponatremia. Ann Intern Med 1984 100 : 777 782.
61. Udelson JE, Smith WB, Hendrix GH. Acute hemodynamic effects of conivaptan, a dual V1A and V2 vasopressin receptor antagonist in patients with advanced heart failure. Circulation 2001 104 : 2417 2423.
62. Schrier RW, Gross P, Gheorghiade M. Tolvaptan, a selective oral vasopressin V2-receptor antagonist for hyponatremia. N Engl J Med 2006 355 : 2099 2112.
63. Vallance P, Moncada S. Hyperdynamic circulation in cirrhosis: a role for nitric oxide? Lancet 1991 337 : 776 778.
64. Ginès P, Guevara M. Hyponatremia in cirrhosis: pathogenesis, clinical significance, and management. Hepatology 2008 48 : 1002 1010.
65. Papadakis MA, Fraser CL, Arieff AI. Hyponatraemia in patients with cirrhosis. Q J Med 1990 76 : 675 688.
66. Heuman DM, Abou-Assi SG, Habib A. Persistent ascites and low serum sodium identify patients with cirrhosis and low MELD scores who are at high risk for early death. Hepatology 2004 40 : 802 810.
67. Gerbes AL, Gulberg V, Gines P. Therapy of hyponatremia in cirrhosis with a vasopressin receptor antagonist: a randomized double-blind multicenter trial. Gastroenterology 2003 124 : 933 939.
68. Tannen RL, Regal EM, Dunn MJ, Schrier RW. Vasopressin-resistant hyposthenuria in advanced chronic renal failure. N Engl J Med 1969 280 : 1135 1141.
69. Milionis HJ, Liamis GL, Elisaf MS. The hyponatremic patient: a systematic approach to laboratory diagnosis. CMAJ 2002 166 : 1056 1062.
70. Hanna F, Scanlon M. Hyponatremia, hypothyroidism and role of arginine vasopressin. Lancet 1997 350 : 755 756.
71. Oelkers W. Hyponatremia and inappropriate secretion of vasopressin in patients with hypopituitarism. N Engl J Med 1989 321 : 492 496.
72. Olchovsky D, Ezra D, Vered I. Symptomatic hyponatremia as a presenting sign of hypothalamic-pituitary disease: s syndrome of inappropriate secretion of antidiuretic hormone (SIADH) - like glucocorticosteroid responsive condition. J Endocrinol Invest 2005 28 : 151 156.
73. Noakes TD, Sharwood K, Speedy D. Three independent biological mechanisms cause exercise-associated hyponatremia: evidence from 2,135 weighed competitive athletic performances. Proc Natl Acad Sci USA 2005 102 : 18550 18555.
74. Freund BJ, Shizuru EM, Hashiro GM, Claybaugh JR. Hormonal, electrolyte, and renal responses to exercise are intensity dependent. J Appl Physiol 1991 70 : 900 906.
75. Davis DP, Videen JS, Marino A. Exercise-associated hyponatremia in marathon runners: a two-year experience. J Emerg Med 2001 21 : 47 57.
76. Hew-Butler T, Ayus JC, Kipps C. Statement of the Second International Exercise-Associated Hyponatremia Consensus Development Conference, New Zealand, 2007. Clin J Sport Med 2008 18 : 111 121.
77. Barlow ED, De Wardener HE. Compulsive water drinking. Q J Med 1959 28 : 235 258.
78. Thompson CJ, Edwards CR, Baylis PH. Osmotic and non-osmotic regulation of thirst and vasopressin secretion in patients with compulsive water drinking. Clin Endocrinol (Oxf) 1991 35 : 221 228.
79. Riggs AT, Dysken MW, Kim SW, Opsahl JA. A review of disorders of water homeostasis in psychiatric patients. Psychosomatics 1991 32 : 133 148.
80. Kawai N, Atsuomi B, Toshihito S, Hiroyasu S. Roles of arginine vasopressin and atrial natriuretic peptide in polydipsia-hyponatremia of schizophrenic patients. Psychiatry Res 2001 101 : 37 45.
81. Hariprasad MK, Eisinger RP, Nadler IM. Hyponatremia in psychogenic polydipsia. Arch Intern Med 1980 140 : 1639 1642.
82. Hilden T, Svendsen TL. Electrolyte disturbances in beer drinkers. Lancet 1975 2 : 245 246.
83. Thaler SM, Teitelbaum I, Berl T. "Beer potomania" in non-beer drinkers: effect of low dietary solute intake. Am J Kidney Dis 1998 31 : 1028 1031.
84. Fox BD. Crash diet potomania. Lancet 2002 359 : 942.
85. Lindheimer M, Davison J. Osmoregulation, the secretion of arginine vasopressin and its metabolism during pregnancy. Eur J Endocrinol 1995 132 : 133 143.
86. Robertson GL, Aycinena P, Zerbe RL. Neurogenic disorders of osmoregulation. Am J Med 1982 72 : 339 353.
87. Kahn T. Reset osmostat and salt and water retention in the course of severe hyponatremia. Medicine 2003 82 : 170 176.
88. Hill AR, Uribarri J, Mann J, Berl T. Altered water metabolism in tuberculosis. Role of vasopressin. Am J Med 1990 88 : 357 364.
89. Tang WW, Kaptein EM, Feinstein EI, Massry SG. Hyponatremia in hospitalized patients with the acquired immunodeficiency syndrome (AIDS) and the AIDS-related complex. Am J Med 1993 94 : 169 174.
90. Vitting KE, Gardenswartz MH, Zabetakis PM. Frequency of hyponatremia and nonosmolar vasopressin release in the acquired immune deficiency syndrome. JAMA 1990 263 : 973 978.
91. Upadhyay A, Jaber BL, Madias NE. Incidence and prevalence of hyponatremia. Am J Med 2006 119 (Suppl. 1 S30 5.
92. Liamis G, Milionis H, Elisaf M. A review of drug-induced hyponatremia. Am J Kidney Dis 2008 52 : 144 153.
93. Chung H-M, Kluge R, Schrier RW, Anderson RJ. Clinical assessment of extracellular fluid volume in hyponatremia. Am J Med 1987 83 : 905 908.
94. Strange K. Regulation of solute and water balance and cell volume in the central nervous system. J Am Soc Nephrol 1992 3 : 12 27.
95. Saeed BO, Beaumont D, Handley GH, Weaver JU. Severe hyponatraemia: investigation and management in a district general hospital. J Clin Pathol 2002 55 : 893 896.
96. Beck LH. Hypouricemia in the syndrome of inappropriate secretion of antidiuretic hormone. N Engl J Med 1979 301 : 528 530.
97. Decaux G, Brimioulle S, Genette F, Mockel J. Treatment of the syndrome of inappropriate secretion of antidiuretic hormone by urea. Am J Med 1980 69 : 99 106. (Pubitemid 10084693)
98. Lauriat SM, Berl T. The hyponatremic patient: practical focus on therapy. J Am Soc Nephrol 1997 8 : 1599 1607.
99. Palmer BF, Gates JR, Lader M. Causes and management of hyponatremia. Ann Pharmacother 2003 37 : 1694 1702.
100. Sterns RH. The treatment of hyponatremia: first, do no harm. Am J Med 1990 88 : 557 560.
101. Rose BD. New approach to disturbances in the plasma sodium concentration. Am J Med 1986 81 : 1033 1040.
102. Musch W, Decaux G. Treating the syndrome of inappropriate ADH secretion with isotonic saline. QJM 1998 91 : 749 753.
103. Chubb SP. Hyponatremia treatment guidelines 2007: expert panel recommendations. Clin Biochem Rev 2009 30 : 35 8.
104. Verbalis JG, Goldsmith SR, Greenberg A, Schrier RW, Sterns RH. Hyponatremia treatment guidelines 2007: expert panel recommendations. Am J Med 2007 120 (11 Suppl 1 S1 21.
105. Zeltser D, Rosansky S, van Rensburg H. Assessment of the efficacy and safety of conivaptan in euvolemic and hypervolemic hyponatremia. Am J Nephrol 2007 27 : 447 457.
106. Ghali JK, Koren MJ, Taylor JR. Efficacy and safety of oral conivaptan: a V1A/V2 vasopressin receptor antagonist, assessed in a randomized, placebo-controlled trial in patients with euvolemic or hypervolemic hyponatremia. J Clin Endocrinol Metab 2006 91 : 2145 2152.
107. Decaux G, Waterlot Y, Genette F, Mockel J. Treatment of the syndrome of inappropriate secretion of antidiuretic hormone with furosemide. N Engl J Med 1981 304 : 329 334.
108. Forrest JN Jr., Cox M, Hong C. Superiority of demeclocycline over lithium in the treatment of chronic syndrome of inappropriate secretion of antidiuretic hormone. N Engl J Med 1978 298 : 173 177.
109. Hensen J, Haenelt M, Gross P. Lithium induced polyuria and renal vasopressin receptor density. Nephrol Dial Transplant 1996 11 : 622 627.