Sodium evolution in hyponatraemia: a mixed effects model analysis of the Hyponatraemia Registry
Authors' conclusion
Choice and dosing of active hyponatraemia therapy should be adjusted not only according to aetiology but most importantly to pretreatment sodium. Although counterintuitive, less aggressive therapy in more profound hyponatraemia might be safer but yet effective at least in less severe cases.
Study context
- Population
- Patients with hyponatraemia from the multinational Hyponatraemia Registry, wide range of aetiologies and treatment strategies
- Participants
- 3,460 patients
- Exposure
- Predictors of plasma sodium evolution in the first 24 h of treatment
- Outcome
- Plasma sodium evolution
- Follow-up
- First 24 h of treatment
Methodological detailsmultinational registry, multivariable linear mixed effects models
- Multinational registry
- Multivariable linear mixed effects models
Main finding
As reported in the abstract
Predictors of sodium evolution · first 24 h
- Baseline sodium: additional increment per 10 mEq/L initial sodium reduction
- 3.12 mEq/L
- Hypovolaemic hyponatraemia: sodium increment per 24 h (independent factor)
- 1.9 mEq/L
- Thiazide-associated hyponatraemia: sodium increment per 24 h (independent factor)
- 1.4 mEq/L
- Hypertonic saline vs no active treatment: significantly larger sodium rise
- 4.6 mEq/L/24 h
- Tolvaptan vs no active treatment: significantly larger sodium rise
- 3.4 mEq/L/24 h
- Combination therapy vs no active treatment: significantly larger sodium rise
- 2.6 mEq/L/24 h
Observational data: associations, not effects.
Original publication
Sodium evolution in hyponatraemia: a mixed effects model analysis of the Hyponatraemia Registry. Eur J Endocrinol. Published 12 June 2023. doi:10.
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