Document Type
Journal Article
Publication Date
2014
Journal
American Journal of Medical Sciences
Abstract
Rapid correction of severe hyponatremia carries the risk of osmotic demyelination. Two recently introduced methods of correction of hyponatremia have diametrically opposite effects on aquaresis. Inhibitors of vasopressin V2 receptor (vaptans) lead to the production of dilute urine, whereas infusion of desmopressin causes urinary concentration. Identification of the category of hyponatremia that will benefit from one or the other treatment is critical. In general, vaptans are effective in hyponatremias presenting with concentrated urine and, with the exception of hypovolemic hyponatremia, can be used as their primary treatment. Desmopressin is effective in hyponatremias presenting with dilute urine or developing urinary dilution after saline infusion. In this setting, desmopressin infusion helps prevent overcorrection of the hyponatremia. Monitoring of the changes in serum sodium concentration as a guide to treatment changes is imperative regardless of the initial treatment of severe hyponatremia.
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.
APA Citation
Tzamaloukas, A.H., Shapiro, J.I., Raj, D.S., Murata, G.H., Glew, R. et al. (2014). Management of severe hyponatremia: Infusion of hypertonic saline and desmopressin or infusion of vasopressin inhibitors? American Journal of Medical Sciences.
Peer Reviewed
1
Open Access
1
Comments
Reproduced with permission of the American Journal of Medical Sciences.