Hypertonic saline, isotonic saline, water restriction, long loops diuretics, urea or vaptans to treat hyponatremia.
Introduction: Hyponatremia is the most common fluid and electrolyte abnormality. It is associated with much higher morbidity and mortality rates than found in non hyponatremic patients.Areas covered: When the physician is faced to a hyponatremic patient he first has to confirm that hyponatremia is associated with hypoosmolality. Then he must answer to a series of questions: What is its origin? Is it acute or chronic? Which treatment is the most appropriate? We will discuss the various options for the treatment of hypotonic hyponatremia. For a better comprehensive approach of the treatment we will also discuss some pathophysiological data. The use of urea in euvolemic and hypervolemic hyponatremia will be particularly discussed. Literature was reviewed from Jan 1970 to Dec 2019.Expert opinion: Prospective studies showing the benefit in decreasing morbidity by increasing SNa in patients with chronic hyponatremia should be done. These studies should also compare the efficacy and side effects of urea therapy compare to vaptans.
['Decaux|Guy|G|', 'Gankam Kengne|Fabrice|F|']
D000208:Acute Disease D065092:Antidiuretic Hormone Receptor Antagonists D001639:Bicarbonates D002908:Chronic Disease D004326:Drinking D006801:Humans D007010:Hyponatremia D017410:Practice Guidelines as Topic D000077330:Saline Solution D012462:Saline Solution, Hypertonic D012964:Sodium D049994:Sodium Potassium Chloride Symporter Inhibitors D000077602:Tolvaptan D014508:Urea D014527:Uric Acid
hypertonic saline urea vaptans Hyponatremia ODS bicarbonate furosemide uric acid