Causes and Management of Hyponatremia

Palmer, Biff F.; Gates, John R.; Lader, Malcolm

doi:10.1345/aph.1d105

Cited by 128 publications

(140 citation statements)

References 60 publications

Supporting

Mentioning

133

Contrasting

Unclassified

Order By: Relevance

“…Hyponatremia is an electrolyte disorder most commonly defined as a serum sodium concentration <135 mEq/ L. 1 Its exact definition can vary across studies, but typically ranges between <130 and <138 mEq/L. 2,3 Signs and symptoms of hyponatremia can include malaise, headache, disorientation, confusion, muscle weakness, and cramps. If severe, seizures, respiratory arrest, brainstem herniation, coma, and death may result.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of incremental healthcare resource burden and readmission rates associated with hospitalized hyponatremic patients in the US

Amin

Deitelzweig

Christian

et al. 2012

Journal of Hospital Medicine

View full text Add to dashboard Cite

BACKGROUND:Hyponatremia is a prevalent electrolyte disorder in hospitalized patients indicative of greater morbidity and mortality. A large‐scale retrospective analysis was conducted to evaluate the incremental burden of hospitalized hyponatremic (HN) versus non‐HN patients in terms of hospital resource utilization, costs, and hospital readmissions in the real‐world setting.METHODS:HN patients (≥18 years) were selected from the Premier Hospital Database between January 1, 2007 and March 31, 2010 and matched to a non‐HN control cohort using propensity score matching. Bivariate and multivariate statistics were employed to evaluate the differences in healthcare resource utilization, costs, and hospital readmissions between patient cohorts.RESULTS:Among the matched patient cohorts, length of stay (LOS) (8.8 ± 10.3 vs 7.7 ± 8.5 days, P < 0.001), hospital admission costs ($15,281 ± $24,054 vs $13,439 ± $22,198, P < 0.001), intensive care unit (ICU) LOS (5.5 ± 7.9 vs 4.9 ± 7.1 days, P < 0.001), and ICU costs ($8525 ± $13,342 vs $7597 ± $12,695, P < 0.001) were greater for the HN versus non‐HN cohort, as were hospital readmission rates 30 days postdischarge. Multivariate regressions further demonstrated that hyponatremia was associated with an increase of 10.9% for LOS, 8.2% for total hospitalization costs, 10.2% for ICU LOS, and 8.9% for ICU costs. Additionally, after multivariate adjustment, hyponatremia was associated with a 15.0% increased chance for hospital readmission 30 days postdischarge (P < 0.0001).CONCLUSIONS:Hyponatremia is an independent predictor of increased hospitalization LOS and cost, ICU admission and cost, and 30‐day hospital readmission, and therefore represents a potential target for intervention to reduce healthcare expenditures for a large population of hospitalized hyponatremic patients. Journal of Hospital Medicine 2012; © 2012 Society of Hospital Medicine

show abstract

Section: Discussionmentioning

confidence: 99%

Evaluation of incremental healthcare resource burden and readmission rates associated with hospitalized hyponatremic patients in the US

Amin

Deitelzweig

Christian

et al. 2012

Journal of Hospital Medicine

View full text Add to dashboard Cite

show abstract

“…In general terms, the treatment of hyponatremia depends on whether or not symptoms are present, their severity and time of onset, and the extracellular volume status of the patient [1,3,28]. Symptomatic patients require prompt attention in order to prevent serious complications.…”

Section: Treatment Optionsmentioning

confidence: 99%

“…Hyponatremia is an electrolyte abnormality commonly encountered in oncology practice and is usually defined by a serum sodium level Ͻ135 mEq/L [1,2]. Although many cases are asymptomatic, hyponatremia may cause neurological symptoms, particularly when serum sodium declines rapidly or by a substantial extent [3].…”

Section: Introductionmentioning

confidence: 99%

Diagnosis and Management of Hyponatremia in Cancer Patients

Castillo

Vincent

Justice³

2012

The Oncologist

209

201

View full text Add to dashboard Cite

Hyponatremia, a common electrolyte abnormality in oncology practice, may be a negative prognostic factor in cancer patients based on a systematic analysis of published studies. The largest body of evidence comes from small-cell lung cancer (SCLC), for which hyponatremia was identified as an independent risk factor for poor outcome in six of 13 studies. Hyponatremia in the cancer patient is usually caused by the syndrome of inappropriate antidiuretic hormone (SIADH), which develops more frequently with SCLC than with other malignancies. SIADH may be driven by ectopic production of arginine vasopressin (AVP) by tumors or by effects of anticancer and palliative medications on AVP production or action. Other factors may cause hypovolemic hyponatremia, including diarrhea and vomiting caused by cancer therapy. Hyponatremia may be detected on routine laboratory testing before or during cancer treatment or may be suggested by the presence of mostly neurological symptoms. Treatment depends on several factors, including symptom severity, onset timing, and extracellular volume status. Appropriate diagnosis is important because treatment differs by etiology, and choosing the wrong approach can worsen the electrolyte abnormality. When hyponatremia is caused by SIADH, hypertonic saline is indicated for acute, symptomatic cases, whereas fluid restriction is recommended to achieve a slower rate of correction for chronic asymptomatic hyponatremia. Pharmacological therapy may be necessary when fluid restriction is insufficient. The orally active, selective AVP receptor 2 (V 2 )-receptor antagonist tolvaptan provides a mechanism-based option for correcting hyponatremia caused by SIADH or other conditions with inappropriate AVP elevations. By blocking AVP effects in the renal collecting duct, tolvaptan promotes aquaresis, leading to a controlled increase in serum sodium levels. The Oncologist 2012;17:756 -765

show abstract

“…Medications such as selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs) are commonly used antidepressants in clinical treatment. Accompanying the therapeutic action, these medications produce a variety of undesirable side effects (Anderson, 2000;Palmer et al, 2003;Krishnan, 2007). To improve life quality of patients and find alternative therapies, a growing number of herbal medicines are being introduced into psychiatric treatment, many of which have a comparable effect to prescription medications with lower side effects (Thachil et al, 2007).…”

Section: Introductionmentioning

confidence: 99%

Effect of aqueous extract and fractions of Zhi-Zi-Hou-Pu decoction against depression in inescapable stressed mice: Restoration of monoamine neurotransmitters in discrete brain regions

Aimin¹,

Ma²,

Zhang³

et al. 2012

Pharmaceutical Biology

View full text Add to dashboard Cite

Causes and Management of Hyponatremia

Abstract: Although hyponatremia can be a serious condition, appropriate measures for the management of at-risk and affected patients will lead to full recovery in most cases.

Cited by 128 publications

References 60 publications

Evaluation of incremental healthcare resource burden and readmission rates associated with hospitalized hyponatremic patients in the US

Evaluation of incremental healthcare resource burden and readmission rates associated with hospitalized hyponatremic patients in the US

Diagnosis and Management of Hyponatremia in Cancer Patients

Effect of aqueous extract and fractions of Zhi-Zi-Hou-Pu decoction against depression in inescapable stressed mice: Restoration of monoamine neurotransmitters in discrete brain regions

Contact Info

Product

Resources

About