Dos and don'ts in the management of hyponatraemia.
Curr Med Res Opin. 2015 Jul 14;:1-26
Authors: Aylwin S, Burst V, Peri A, Runkle I, Thatcher N
Abstract
Introduction and objective The management of hyponatraemia has evolved in recent years, particularly with the introduction of tolvaptan for hyponatraemia secondary to the syndrome of inappropriate antidiuretic hormone secretion (SIADH). This commentary presents a summary of recent international recommendations in the form of a series of didactic 'dos and don'ts', in order to provide concise, practical guidance for practising clinicians focused on the investigation and management of euvolaemic hyponatraemia (SIADH). Research methods A multidisciplinary group of international experts reviewed existing guidelines and the evidence cited within to summarise the recommendations in a practical method for use in clinical practice. Recommendations The 'dos and don'ts' are presented under topic headings that include diagnosis and diagnostic tests, specific causes, correction of acute hyponatraemia, correction rates for chronic hyponatraemia, management of SIADH including fluid restriction, hypertonic saline and pharmacological strategies, and management of overcorrection. Within each topic, the authors summarise the published recommendations on managing hyponatraemia and the use of specific agents for the treatment of SIADH. Conclusion Practising clinicians can use these 'dos and don'ts' to provide clear, up-to-date guidance on how to manage hyponatraemia and the use of tolvaptan in SIADH.
PMID: 26173050 [PubMed - as supplied by publisher]