A Patient With Severe Hyponatremia and Hypokalemia: Osmotic Demyelination Following Potassium Repletion

American Journal of Kidney Diseases

Volumn 55, Issue 4, 2010, Pages 742-748

  Berl, Tomas ^a   Rastegar, Asghar ^b  

^a UNIVERSITY OF COLORADO   (United States)

^b YALE UNIVERSITY SCHOOL OF MEDICINE   (United States)

Author keywords

hypokalemia; Hyponatremia; osmotic demyelination

Indexed keywords

AMOXICILLIN PLUS CLAVULANIC ACID; DESLORATADINE; DESMOPRESSIN; HYDROCHLOROTHIAZIDE; HYDROCHLOROTHIAZIDE PLUS LOSARTAN; METOLAZONE; NAPROXEN; NONSTEROID ANTIINFLAMMATORY AGENT; PHOSPHATE; POTASSIUM CHLORIDE; SIMVASTATIN; THIAZIDE DIURETIC AGENT;

ADULT; ARTICLE; CASE REPORT; CLINICAL FEATURE; DEMYELINATION; DISEASE ASSOCIATION; DISEASE SEVERITY; DRUG MECHANISM; ELBOW PAIN; FEMALE; HUMAN; HYPERTENSION; HYPOKALEMIA; HYPONATREMIA; NUCLEAR MAGNETIC RESONANCE IMAGING; OSMOTIC DEMYELINATING SYNDROME; PAIN; PATHOPHYSIOLOGY; POTASSIUM BLOOD LEVEL; SODIUM BLOOD LEVEL; UNSPECIFIED SIDE EFFECT;

DEMYELINATING DISEASES; FEMALE; HUMANS; HYPOKALEMIA; HYPONATREMIA; MIDDLE AGED; OSMOSIS; POTASSIUM CHLORIDE; SEVERITY OF ILLNESS INDEX; SODIUM CHLORIDE SYMPORTER INHIBITORS;

EID: 77949558804     PISSN: 02726386     EISSN: None     Source Type: Journal    
DOI: 10.1053/j.ajkd.2009.12.024     Document Type: Article

References (32)

1. Nguyen M.K., Ornekian V., Butch A.W., and Kurtz I. A new method for determining plasma water content: application in pseudohyponatremia. Am J Physiol Renal Physiol 292 5 (2007) F1652-F1656
2. Fuisz R.E., Lauler D.P., and Cohen P. Diuretic-induced hyponatremia and sustained antidiuresis. Am J Med 33 (1962) 783-791
3. Byatt C.M., Millard P.H., and Levin G.E. Diuretics and electrolyte disturbances in 1000 consecutive geriatric admissions. J R Soc Med 83 11 (1990) 704-708
4. Sonnenblick M., Friedlander Y., and Rosin A.J. Diuretic-induced severe hyponatremia. Review and analysis of 129 reported patients. Chest 103 2 (1993) 601-606
5. Fichman M.P., Vorherr H., Kleeman C.R., and Telfer N. Diuretic-induced hyponatremia. Ann Intern Med 75 6 (1971) 853-863
6. Ashraf N., Locksley R., and Arieff A.I. Thiazide-induced hyponatremia associated with death or neurologic damage in outpatients. Am J Med 70 6 (1981) 1163-1168
7. Friedman E., Shadel M., Halkin H., and Farfel Z. Thiazide-induced hyponatremia. Reproducibility by single dose rechallenge and an analysis of pathogenesis. Ann Intern Med 110 1 (1989) 24-30
8. Chow K.M., Szeto C.C., Wong T.Y., Leung C.B., and Li P.K. Risk factors for thiazide-induced hyponatraemia. QJM 96 12 (2003) 911-917
9. Sharabi Y., Illan R., Kamari Y., et al. Diuretic induced hyponatraemia in elderly hypertensive women. J Hum Hypertens 16 9 (2002) 631-635
10. Ghose R.R. Plasma arginine vasopressin in hyponatraemic patients receiving diuretics. Postgrad Med J 61 722 (1985) 1043-1046
11. Kim G.H., Lee J.W., Oh Y.K., et al. Antidiuretic effect of hydrochlorothiazide in lithium-induced nephrogenic diabetes insipidus is associated with upregulation of aquaporin-2, Na-Cl co-transporter, and epithelial sodium channel. J Am Soc Nephrol 15 11 (2004) 2836-2843
12. Cesar K.R., and Magaldi A.J. Thiazide induces water absorption in the inner medullary collecting duct of normal and Brattleboro rats. Am J Physiol 277 5 pt 2 (1999) F756-F760
13. Marples D., Frokiaer J., Dorup J., Knepper M.A., and Nielsen S. Hypokalemia-induced downregulation of aquaporin-2 water channel expression in rat kidney medulla and cortex. J Clin Invest 97 8 (1996) 1960-1968
14. Spital A. Diuretic-induced hyponatremia. Am J Nephrol 19 4 (1999) 447-452
15. Edelman I.S., Leibman J., O'Meara M.P., and Birkenfeld L.W. Interrelations between serum sodium concentration, serum osmolarity and total exchangeable sodium, total exchangeable potassium and total body water. J Clin Invest 37 9 (1958) 1236-1256
16. Heppel L. The electrolytes of muscle and liver in potassium-depleted rats. Am J Physiol 127 (1939) 385-392
17. Ferrebee J., Parker D., Carnes W.H., Gerity M.K., Atchley D.W., and Loeb R.F. Certain effects of desoxycorticosterone. Am J Physiol 135 (1941) 230-237
18. Laragh J.H. The effect of potassium chloride on hyponatremia. J Clin Invest 33 5 (1954) 807-818
19. Nguyen M.K., and Kurtz I. Role of potassium in hypokalemia-induced hyponatremia: lessons learned from the Edelman equation. Clin Exp Nephrol 8 2 (2004) 98-102
20. Stoff J.S., Rosa R.M., Silva P., and Epstein F.H. Indomethacin impairs water diuresis in the DI rat: role of prostaglandins independent of ADH. Am J Physiol 241 3 (1981) F231-F237
21. Stokes J.B. Integrated actions of renal medullary prostaglandins in the control of water excretion. Am J Physiol 240 6 (1981) F471-F480
22. Rault R.M. Case report: hyponatremia associated with nonsteroidal antiinflammatory drugs. Am J Med Sci 305 5 (1993) 318-320
23. Sterns R.H., Cappuccio J.D., Silver S.M., and Cohen E.P. Neurologic sequelae after treatment of severe hyponatremia: a multicenter perspective. J Am Soc Nephrol 4 8 (1994) 1522-1530
24. Kamel K.S., and Bear R.A. Treatment of hyponatremia: a quantitative analysis. Am J Kidney Dis 21 4 (1993) 439-443
25. Rose B.D. New approach to disturbances in the plasma sodium concentration. Am J Med 81 6 (1986) 1033-1040
26. Maallem S., Mutin M., Gonzalez-Gonzalez I.M., Zafra F., and Tappaz M.L. Selective tonicity-induced expression of the neutral amino-acid transporter SNAT2 in oligodendrocytes in rat brain following systemic hypertonicity. Neuroscience 153 1 (2008) 95-107
27. Lohr J.W. Osmotic demyelination syndrome following correction of hyponatremia: association with hypokalemia. Am J Med 96 5 (1994) 408-413
28. Soupart A., Penninckx R., Crenier L., Stenuit A., Perier O., and Decaux G. Prevention of brain demyelination in rats after excessive correction of chronic hyponatremia by serum sodium lowering. Kidney Int 45 1 (1994) 193-200
29. Gankam Kengne F., Soupart A., Pochet R., Brion J.P., and Decaux G. Re-induction of hyponatremia after rapid overcorrection of hyponatremia reduces mortality in rats. Kidney Int 76 (2009) 614-621
30. Soupart A., Ngassa M., and Decaux G. Therapeutic relowering of the serum sodium in a patient after excessive correction of hyponatremia. Clin Nephrol 51 6 (1999) 383-386
31. Oya S., Tsutsumi K., Ueki K., and Kirino T. Reinduction of hyponatremia to treat central pontine myelinolysis. Neurology 57 10 (2001) 1931-1932
32. Perianayagam A., Sterns R.H., Silver S.M., et al. DDAVP is effective in preventing and reversing inadvertent overcorrection of hyponatremia. Clin J Am Soc Nephrol 3 2 (2008) 331-336