Ten pitfalls in the proper management of patients with hyponatremia

Postgraduate Medicine

Volumn 128, Issue 5, 2016, Pages 516-522

  Filippatos, Theodosios D ^a   Liamis, George ^a   Elisaf, Moses S ^a  

^a UNIVERSITY OF IOANNINA   (Greece)

Author keywords

formulas; hyponatremia; overcorrection; Sodium; syndrome of inappropriate antidiuretic hormone secretion; treatment; vaptans

Indexed keywords

CONIVAPTAN; DEMECLOCYCLINE; DESMOPRESSIN; FUROSEMIDE; POTASSIUM; SODIUM CHLORIDE; TOLVAPTAN; VASOPRESSIN; VASOPRESSIN RECEPTOR ANTAGONIST; DIURETIC AGENT; SODIUM; THIAZIDE DIURETIC AGENT;

DEHYDRATION; DIURESIS; ENDOCRINE DISEASE; HIGH RISK PATIENT; HUMAN; HYPERVOLEMIA; HYPOKALEMIA; HYPONATREMIA; KIDNEY POLYCYSTIC DISEASE; LIVER DISEASE; MALNUTRITION; NEUROLOGIC DISEASE; REVIEW; SODIUM BLOOD LEVEL; SYNDROME OF INAPPROPRIATE ANTIDIURETIC HORMONE SECRETION; TOXIC HEPATITIS; URINALYSIS; URINE OSMOLALITY; URINE VOLUME; WATER INTOXICATION; ACUTE DISEASE; ADVERSE EFFECTS; BLOOD; CHRONIC DISEASE; COMPLICATION; DOSE CALCULATION; FLUID THERAPY; HYPOVOLEMIA; INAPPROPRIATE ADH SYNDROME; MATHEMATICAL PHENOMENA; MEDICAL ERROR;

ACUTE DISEASE; ANTIDIURETIC HORMONE RECEPTOR ANTAGONISTS; CHRONIC DISEASE; DIURETICS; DRUG DOSAGE CALCULATIONS; FLUID THERAPY; FUROSEMIDE; HUMANS; HYPONATREMIA; HYPOVOLEMIA; INAPPROPRIATE ADH SYNDROME; MATHEMATICAL CONCEPTS; MEDICAL ERRORS; SODIUM; THIAZIDES;

EID: 84978409987     PISSN: 00325481     EISSN: 19419260     Source Type: Journal    
DOI: 10.1080/00325481.2016.1186488     Document Type: Review

References (64)

1. G.Liamis, E.M.Rodenburg, A.Hofman, et al. Electrolyte disorders in community subjects: prevalence and risk factors. Am J Med. 2013;126:256–263.
2. T.D.Filippatos, M.S.Elisaf Hyponatremia in patients with heart failure. World J Cardiol. 2013;5:317–328.
3. T.D.Filippatos, G.Liamis, F.Christopoulou, et al. Ten common pitfalls in the evaluation of patients with hyponatremia. Eur J Intern Med. 2016;29:22–25.
4. F.Gankam Kengne, C.Andres, L.Sattar, et al. Mild hyponatremia and risk of fracture in the ambulatory elderly. QJM. 2008;101:583–588.
5. B.Renneboog, W.Musch, X.Vandemergel, et al. Mild chronic hyponatremia is associated with falls, unsteadiness, and attention deficits. Am J Med. 2006;119:71 e1–8.
6. E.J.Hoorn, F.Rivadeneira, J.B.Van Meurs, et al. Mild hyponatremia as a risk factor for fractures: the Rotterdam Study. J Bone Miner Res. 2011;26:1822–1828.
7. E.J.Hoorn, G.Liamis, R.Zietse, et al. Hyponatremia and bone: an emerging relationship. Nat Rev Endocrinol. 2012;8:33–39.
8. D.M.Snell, C.Bartley. Osmotic demyelination syndrome following rapid correction of hyponatraemia. Anaesthesia. 2008;63:92–95.
9. A.N.Tavare, D.Murray. Central pontine myelinolysis. N Engl J Med. 2016;374:e8.
10. T.D.Singh, J.E.Fugate, A.A.Rabinstein. Central pontine and extrapontine myelinolysis: a systematic review. Eur J Neurol. 2014;21:1443–1450.
11. J.G.Verbalis, S.R.Goldsmith, A.Greenberg, et al. Diagnosis, evaluation, and treatment of hyponatremia: expert panel recommendations. Am J Med. 2013;126:S1–S42.
12. G.Spasovski, R.Vanholder, B.Allolio, et al. Clinical practice guideline on diagnosis and treatment of hyponatraemia. Nephrol Dial Transplant. 2014;29(Suppl 2):i1–i39.
13. G.Liamis, H.J.Milionis, M.Elisaf. Endocrine disorders: causes of hyponatremia not to neglect. Ann Med. 2011;43:179–187.
14. G.Liamis, H.Milionis, M.Elisaf. A review of drug-induced hyponatremia. Am J Kidney Dis. 2008;52:144–153.
15. J.C.Ayus, J.M.Wheeler, A.I.Arieff. Postoperative hyponatremic encephalopathy in menstruant women. Ann Intern Med. 1992;117:891–897.
16. H.J.Adrogue, N.E.Madias. Diagnosis and treatment of hyponatremia. Am J Kidney Dis. 2014;64:681–684.
17. G.Liamis, M.Elisaf. Treatment of hyponatremia: what the clinician needs to know. J Nephrol Res. 2015;1:19–21.
18. R.Pallavi. An unsuspected cause of hyponatremia: beer potomania. J Am Geriatr Soc. 2015;63:1714–1715.
19. W.Srisung, C.Mankongpaisarnrung, C.Anaele, et al. A rare case of low-solute hyponatremia in a nonalcoholic person. Case Rep Nephrol Dial. 2015;5:49–53.
20. S.M.Thaler, I.Teitelbaum, T.Berl. “Beer potomania” in non-beer drinkers: effect of low dietary solute intake. Am J Kidney Dis. 1998;31:1028–1031.
21. T.Berl, A.Rastegar. A patient with severe hyponatremia and hypokalemia: osmotic demyelination following potassium repletion. Am J Kidney Dis. 2010;55:742–748.
22. C.Dellabarca, K.S.Servilla, B.Hart, et al. Osmotic myelinolysis following chronic hyponatremia corrected at an overall rate consistent with current recommendations. Int Urol Nephrol. 2005;37:171–173.
23. J.W.Lohr. Osmotic demyelination syndrome following correction of hyponatremia: association with hypokalemia. Am J Med. 1994;96:408–413.
24. H.K.Mohmand, D.Issa, Z.Ahmad, et al. Hypertonic saline for hyponatremia: risk of inadvertent overcorrection. Clin J Am Soc Nephrol. 2007;2:1110–1117.
25. G.Liamis, M.Kalogirou, V.Saugos, et al. Therapeutic approach in patients with dysnatraemias. Nephrol Dial Transplant. 2006;21:1564–1569.
26. B.Rose. Hypoosmolal states – hyponatremia. In: Clinical physiology of acid-base and electrolyte disorders. 4th ed. New York (NY): McGraw-Hill; 1994. p. 651–694.
27. A.Duggal, P.Yadav, A.Agarwal, et al. Clinical approach to altered serum sodium levels. JIACM. 2006;7:91–103.
28. H.J.Adrogue, N.E.Madias. Hyponatremia. N Engl J Med. 2000;342:1581–1589.
29. G.Liamis, T.D.Filippatos, M.S.Elisaf. Correction of hypovolemia with crystalloid fluids: individualizing infusion therapy. Postgrad Med. 2015;127:405–412.
30. D.H.Ellison, T.Berl. Clinical practice. The syndrome of inappropriate antidiuresis. N Engl J Med. 2007;356:2064–2072.
31. N.Janicic, J.G.Verbalis. Evaluation and management of hypo-osmolality in hospitalized patients. Endocrinol Metab Clin North Am. 2003;32:459–481. vii.
32. K.S.Hwang, G.-H.Kim. Thiazide-induced hyponatremia. Electrolyte Blood Press. 2010;8:51–57.
33. G.Liamis, M.Elisaf. Syndrome of inappropriate antidiuresis associated with multiple sclerosis. J Neurol Sci. 2000;172:38–40.
34. H.J.Milionis, G.L.Liamis, M.S.Elisaf. The hyponatremic patient: a systematic approach to laboratory diagnosis. CMAJ. 2002;166:1056–1062.
35. G.Spasovski, R.Vanholder, B.Allolio, et al. Clinical practice guideline on diagnosis and treatment of hyponatraemia. Eur J Endocrinol. 2014;170:G1–G47.
36. A.S.Shoker. Application of the clearance concept to hyponatremic and hypernatremic disorders: a phenomenological analysis. Clin Chem. 1994;40:1220–1227.
37. H.Furst, H.Kr, J.Post, et al. The urine/plasma electrolyte ratio: a predictive guide to water restriction. Am J Med Sci. 2000;319:240–244.
38. R.H.Sterns, S.M.Silver, J.K.Hix. Urea for hyponatremia? Kidney Int. 2015;87:268–270.
39. F.Gankam Kengne, B.S.Couturier, A.Soupart, et al. Urea minimizes brain complications following rapid correction of chronic hyponatremia compared with vasopressin antagonist or hypertonic saline. Kidney Int. 2015;87:323–331.
40. R.De Las Penas, S.Ponce, F.Henao, et al. SIADH-related hyponatremia in hospital day care units: clinical experience and management with tolvaptan. Support Care Cancer. 2016;24:499–507.
41. P.Tzoulis, J.A.Waung, E.Bagkeris, et al. Real-life experience of tolvaptan use in the treatment of severe hyponatraemia due to syndrome of inappropriate antidiuretic hormone secretion. Clin Endocrinol (Oxf). 2016;84:620–626.
42. C.Petereit, O.Zaba, I.Teber, et al. A rapid and efficient way to manage hyponatremia in patients with SIADH and small cell lung cancer: treatment with tolvaptan. BMC Pulm Med. 2013;13:55.
43. H.J.Adrogue, N.E.Madias. Aiding fluid prescription for the dysnatremias. Intensive Care Med. 1997;23:309–316.
44. N.R.Barsoum, B.S.Levine. Current prescriptions for the correction of hyponatraemia and hypernatraemia: are they too simple? Nephrol Dial Transplant. 2002;17:1176–1180.
45. H.J.Adrogue, N.E.Madias. The challenge of hyponatremia. J Am Soc Nephrol. 2012;23:1140–1148.
46. L.Sood, R.H.Sterns, J.K.Hix, et al. Hypertonic saline and desmopressin: a simple strategy for safe correction of severe hyponatremia. Am J Kidney Dis. 2013;61:571–578.
47. B.Rose, T.Post. Clinical physiology of acid-base and electrolyte disorders. 5th ed. New York (NY): McGraw-Hill; 2001.
48. W.T.Abraham, G.Decaux, R.C.Josiassen, et al. Oral lixivaptan effectively increases serum sodium concentrations in outpatients with euvolemic hyponatremia. Kidney Int. 2012;82:1215–1222.
49. G.Liamis, T.D.Filippatos, M.S.Elisaf. Treatment of hyponatremia: the role of lixivaptan. Expert Rev Clin Pharmacol. 2014;7:431–441.
50. R.W.Lehrich, D.I.Ortiz-Melo, M.B.Patel, et al. Role of vaptans in the management of hyponatremia. Am J Kidney Dis. 2013;62:364–376.
51. A.Greenberg, J.G.Verbalis, A.N.Amin, et al. Current treatment practice and outcomes. Report of the hyponatremia registry. Kidney Int. 2015;88:167–177.
52. H.Fukui. Do vasopressin V2 receptor antagonists benefit cirrhotics with refractory ascites? World J Gastroenterol. 2015;21:11584–11596.
53. T.Kogiso, K.Tokushige, E.Hashimoto, et al. Safety and efficacy of long-term tolvaptan therapy for decompensated liver cirrhosis. Hepatol Res. 2016;46:E194–E200.
54. L.Yan, F.Xie, J.Lu, et al. The treatment of vasopressin V2-receptor antagonists in cirrhosis patients with ascites: a meta-analysis of randomized controlled trials. BMC Gastroenterol. 2015;15:65.
55. S.O.P.C.Tolvaptansummary of product characteristics. [cited 2015 Oct 24]. Available from: http://www.otsukapharma.info/medical-professionals/samsca/pdf/Samsca15mg-SPC-Eng-201108.pdf.
56. Tolvaptan prescribing information. [cited 2015 Oct 24]. Available from: http://www.accessdata.fda.gov/drugsatfda_docs/label/2013/022275s009lbl.pdf.
57. P.B.Watkins, J.H.Lewis, N.Kaplowitz, et al. Clinical pattern of tolvaptan-associated liver injury in subjects with autosomal dominant polycystic kidney disease: analysis of clinical trials database. Drug Saf. 2015;38:1103–1113.
58. V.E.Torres, A.B.Chapman, O.Devuyst, et al. Tolvaptan in patients with autosomal dominant polycystic kidney disease. N Engl J Med. 2012;367:2407–2418.
59. Tolvaptan-FDA drug safety communication. [cited 2015 Oct 24]. Available from: http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm350185.htm.
60. B.F.Palmer, A.D.Rock, E.J.Woodward. Dose comparison of conivaptan (Vaprisol(R)) in patients with euvolemic or hypervolemic hyponatremia – efficacy, safety, and pharmacokinetics. Drug Des Devel Ther. 2016;10:339–351.
61. M.Dominguez, J.A.Perez, C.B.Patel. Efficacy of 3% saline vs. conivaptan in achieving hyponatremia treatment goals. Methodist Debakey Cardiovasc J. 2013;9:49–53.
62. S.O.P.C.Conivaptansummary of product characteristics [Internet; cited 2015 Oct 24]. Available from: http://www.vaprisol.com/pdf/Vaprisol-PI-Apr2015.pdf.
63. R.H.Sterns, J.K.Hix. Overcorrection of hyponatremia is a medical emergency. Kidney Int. 2009;76:587–589.
64. A.Perianayagam, R.H.Sterns, S.M.Silver, et al. DDAVP is effective in preventing and reversing inadvertent overcorrection of hyponatremia. Clin J Am Soc Nephrol. 2008;3:331–336.