Clinical practice guideline on diagnosis and treatment of hyponatraemia

Eur J Endocrinol. 2014 Feb 25;170(3):G1-47. doi: 10.1530/EJE-13-1020. Print 2014 Mar.


Hyponatraemia, defined as a serum sodium concentration <135 mmol/l, is the most common disorder of body fluid and electrolyte balance encountered in clinical practice. It can lead to a wide spectrum of clinical symptoms, from subtle to severe or even life threatening, and is associated with increased mortality, morbidity and length of hospital stay in patients presenting with a range of conditions. Despite this, the management of patients remains problematic. The prevalence of hyponatraemia in widely different conditions and the fact that hyponatraemia is managed by clinicians with a broad variety of backgrounds have fostered diverse institution- and speciality-based approaches to diagnosis and treatment. To obtain a common and holistic view, the European Society of Intensive Care Medicine (ESICM), the European Society of Endocrinology (ESE) and the European Renal Association - European Dialysis and Transplant Association (ERA-EDTA), represented by European Renal Best Practice (ERBP), have developed the Clinical Practice Guideline on the diagnostic approach and treatment of hyponatraemia as a joint venture of three societies representing specialists with a natural interest in hyponatraemia. In addition to a rigorous approach to methodology and evaluation, we were keen to ensure that the document focused on patient-important outcomes and included utility for clinicians involved in everyday practice.

Publication types

  • Practice Guideline
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Algorithms
  • Blood Glucose / metabolism
  • Brain Edema / therapy
  • Critical Care / organization & administration
  • Endocrinology / organization & administration
  • Evidence-Based Medicine
  • Female
  • Humans
  • Hyponatremia / blood
  • Hyponatremia / diagnosis*
  • Hyponatremia / therapy*
  • Hyponatremia / urine
  • Inappropriate ADH Syndrome / complications
  • Infusions, Intravenous
  • Kidney Diseases / physiopathology
  • Male
  • Nephrology / organization & administration
  • Osmolar Concentration
  • Saline Solution, Hypertonic / administration & dosage
  • Sodium / blood
  • Sodium / urine
  • Vasopressins / metabolism
  • Vasopressins / physiology


  • Blood Glucose
  • Saline Solution, Hypertonic
  • Vasopressins
  • Sodium