Universität zu Köln

Greenberg, Arthur, Verbalis, Joseph G., Amin, Alpesh N., Burst, Volker R., Chiodo, Joseph A., III, Chiong, Jun R., Dasta, Joseph F., Friend, Keith E., Hauptman, Paul J., Peri, Alessandro and Sigal, Samuel H. (2015). Current treatment practice and outcomes. Report of the hyponatremia registry. Kidney Int., 88 (1). S. 167 - 178. NEW YORK: ELSEVIER SCIENCE INC. ISSN 1523-1755

Full text not available from this repository.

Abstract

Current management practices for hyponatremia (HN) are incompletely understood. The HN Registry has recorded diagnostic measures, utilization, efficacy, and outcomes of therapy for eu- or hypervolemic HN. To better understand current practices, we analyzed data from 3087 adjudicated adult patients in the registry with serum sodium concentration of 130 mEq/l or less from 225 sites in the United States and European Union. Common initial monotherapy treatments were fluid restriction (35%), administration of isotonic (15%) or hypertonic saline (2%), and tolvaptan (5%); 17% received no active agent. Median (interquartile range) mEq/l serum sodium increases during the first day were as follows: no treatment, 1.0 (0.0-4.0); fluid restriction, 2.0 (0.0-4.0); isotonic saline, 3.0 (0.0-5.0); hypertonic saline, 5.0 (1.0-9.0); and tolvaptan, 4.0 (2.0-9.0). Adjusting for initial serum sodium concentration with logistic regression, the relative likelihoods for correction by 5 mEq/l or more (referent, fluid restriction) were 1.60 for hypertonic saline and 2.55 for tolvaptan. At discharge, serum sodium concentration was under 135 mEq/l in 78% of patients and 130 mEq/l or less in 49%. Overly rapid correction occurred in 7.9%. Thus, initial HN treatment often uses maneuvers of limited efficacy. Despite an association with poor outcomes and availability of effective therapy, most patients with HN are discharged from hospital still hyponatremic. Studies to assess short- and long-term benefits of correction of HN with effective therapies are needed.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Greenberg, Arthur UNSPECIFIED UNSPECIFIED UNSPECIFIED Verbalis, Joseph G. UNSPECIFIED UNSPECIFIED UNSPECIFIED Amin, Alpesh N. UNSPECIFIED UNSPECIFIED UNSPECIFIED Burst, Volker R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Chiodo, Joseph A., III UNSPECIFIED UNSPECIFIED UNSPECIFIED Chiong, Jun R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Dasta, Joseph F. UNSPECIFIED UNSPECIFIED UNSPECIFIED Friend, Keith E. UNSPECIFIED UNSPECIFIED UNSPECIFIED Hauptman, Paul J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Peri, Alessandro UNSPECIFIED UNSPECIFIED UNSPECIFIED Sigal, Samuel H. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-399776
DOI:	10.1038/ki.2015.4
Journal or Publication Title:	Kidney Int.
Volume:	88
Number:	1
Page Range:	S. 167 - 178
Date:	2015
Publisher:	ELSEVIER SCIENCE INC
Place of Publication:	NEW YORK
ISSN:	1523-1755
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language SERUM SODIUM; INAPPROPRIATE SECRETION; HEART-FAILURE; MORTALITY; DIAGNOSIS; EPIDEMIOLOGY; MANAGEMENT; TOLVAPTAN; EFFICACY; CARE Multiple languages Urology & Nephrology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/39977