Neurofilament light chain and glial fibrillary acidic protein as potential early indicators of osmotic brain stress in hyponatremia and its correction
Authors' conclusion
Hyponatremia and its correction are associated with measurable neuronal and astrocytic injury. NfL and GFAP may serve as early indicators of osmotic brain stress, suggesting ODS may represent only the visible part of a broader spectrum of cerebral vulnerability.
Study context
- Population
- Healthy adults with experimentally induced hyponatremia, and hospitalized patients with hyponatremia2 RCTs
- Comparison
- Healthy adults vs Hyponatremia
Methodological detailsdouble-blind, placebo-controlled
- Double-blind
- Placebo-controlled
Primary result
As reported in the abstract
- Healthy adults: blood sodium decrease within 8 hours, median (mmol/L)
- 7 [−8(-)-6]
- Healthy adults: NfL increase (Z-units)
- +0.48 [0.09-0.78]
- Healthy adults: Glial fibrillary acidic protein (GFAP) increase (Z-units)
- +1.02 [0.84-1.39]
- Hyponatremia patients: baseline sodium (mmol/L)
- 126 [122-127]
- Hyponatremia patients: sodium increase within 24 hours (mmol/L)
- 4 [2-6]
- Hyponatremia patients: NfL Z-score baseline; increase
- 1.90 [1.06-2.51]; +0.21 [−0.03-0.66]
- Hyponatremia patients: GFAP Z-score baseline; increase
- 0.16 [−0.55-0.58]; +0.46 [0.12-0.81]
Further findings
Predictors of biomarker Z-scores on day 5 (multivariable models)
- Baseline biomarker levels and degree of sodium increase within 24 hours were significant predictors
Original publication
Neurofilament light chain and glial fibrillary acidic protein as potential early indicators of osmotic brain stress in hyponatremia and its correction. Eur J Endocrinol. Published 16 June 2026. doi:10.
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