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. 2013 Oct;126(10 Suppl 1):S1-42.
doi: 10.1016/j.amjmed.2013.07.006.

Diagnosis, Evaluation, and Treatment of Hyponatremia: Expert Panel Recommendations


Diagnosis, Evaluation, and Treatment of Hyponatremia: Expert Panel Recommendations

Joseph G Verbalis et al. Am J Med. .


Hyponatremia is a serious, but often overlooked, electrolyte imbalance that has been independently associated with a wide range of deleterious changes involving many different body systems. Untreated acute hyponatremia can cause substantial morbidity and mortality as a result of osmotically induced cerebral edema, and excessively rapid correction of chronic hyponatremia can cause severe neurologic impairment and death as a result of osmotic demyelination. The diverse etiologies and comorbidities associated with hyponatremia pose substantial challenges in managing this disorder. In 2007, a panel of experts in hyponatremia convened to develop the Hyponatremia Treatment Guidelines 2007: Expert Panel Recommendations that defined strategies for clinicians caring for patients with hyponatremia. In the 6 years since the publication of that document, the field has seen several notable developments, including new evidence on morbidities and complications associated with hyponatremia, the importance of treating mild to moderate hyponatremia, and the efficacy and safety of vasopressin receptor antagonist therapy for hyponatremic patients. Therefore, additional guidance was deemed necessary and a panel of hyponatremia experts (which included all of the original panel members) was convened to update the previous recommendations for optimal current management of this disorder. The updated expert panel recommendations in this document represent recommended approaches for multiple etiologies of hyponatremia that are based on both consensus opinions of experts in hyponatremia and the most recent published data in this field.

Keywords: Antidiuretic hormone; Aquaretics; Hypo-osmolality; Natriuresis; Syndrome of inappropriate antidiuretic hormone secretion; Vasopressin; Volume regulation.

Comment in

  • Panel recommendations on hyponatremia.
    Gross P. Gross P. Am J Med. 2014 Jul;127(7):e29. doi: 10.1016/j.amjmed.2013.11.016. Epub 2013 Dec 17. Am J Med. 2014. PMID: 24361209 No abstract available.
  • The reply.
    Verbalis JG, Goldsmith SR, Greenberg A, Korzelius C, Schrier RW, Sterns RH, Thompson CJ. Verbalis JG, et al. Am J Med. 2014 Jul;127(7):e31-2. doi: 10.1016/j.amjmed.2014.03.022. Am J Med. 2014. PMID: 24970609 No abstract available.

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