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Recent Advances in Hyponatremia

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Hyponatremia is the most common electrolyte abnormality in both the inpatient and outpatient setting in both children and adults. Hyponatremia primarily results from the combination of impaired free water excretion due to elevated vasopressin levels in conjunction with a source of free water intake. The ...

Hyponatremia is the most common electrolyte abnormality in both the inpatient and outpatient setting in both children and adults. Hyponatremia primarily results from the combination of impaired free water excretion due to elevated vasopressin levels in conjunction with a source of free water intake. The majority of cases of hyponatremia in hospitalized patients develop is hospital and are related to the administration of hypotonic intravenous fluids. There is mounting evidence that hyponatremia is an independent risk for factor for mortality in both the ambulatory and hospital settings, particularly in patients with end-stage liver disease, congestive heart failure, pneumonia and end stage renal disease. It is now recognized that mild and chronic hyponatremia can results in subtle neurologic impairment leading to falls and associated bone fractures in the elderly, with increased bone fragility resulting from bone demineralization. Hyponatremia results in a significant health care burden and results in increased medical costs and hospital stay. There is emerging evidence that hyponatremia may alter the immune response and could explain why there is an increased association of infections in hyponatremic patients.
Hyponatremia is a multifactorial condition , where the management will vary depending on the underlying disease and etiology of hyponatremia. Serum and urinary biochemistries can aid in determining the etiology of hyponatremia. There are various therapies available for the treatment of hyponatremia, most of which have not been formally studied in great detail. Vasopressin (V2) antagonists are a relatively new medication for the treatment of hyponatremia with a still undefined role in clinical practice.
The most serious complication of hyponatremia is hyponatremic encephalopathy, which is a medical emergency that can be fatal or lead to irreversible brain injury if inadequately treated. Overcorrection of severe and chronic hyponatremia can also produce neurologic injury from cerebral demyelination. The management of hyponatremia is complicated as there are various risk factors for both the development of symptomatic hyponatremia and for a the development of demyelination syndrome, and these risk factors need to be taken into account when evaluating and managing a patient.

This research topic will explore the recent advances in hyponatremia in both children and adults. Original research, case studies, reviews and commentaries are welcome that will better define the epidemiology, pathogenesis, prevention, evaluation and treatment of hyponatremia. The research topic will provide a deeper understanding of the impact of hyponatremia and the adverse consequences related to it.


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