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World J Clin Cases. Aug 16, 2013; 1(5): 155-158
Published online Aug 16, 2013. doi: 10.12998/wjcc.v1.i5.155
Published online Aug 16, 2013. doi: 10.12998/wjcc.v1.i5.155
Desmopression is an effective adjunct treatment for reversing excessive hyponatremia overcorrection
Kamel A Gharaibeh, Matthew J Craig, Christian A Koch, Tibor Fülöp, Éva Csongrádi, Department of Internal Medicine, University of Mississippi Medical Center, Jackson, MS 39216-4505, United States
Anna A Lerant, Department of Anesthesiology, University of Mississippi Medical Center, Jackson, MS 39216-4505, United States
Éva Csongrádi, Department of Medicine, University of Debrecen Medical and Health Science Centre, University of Debrecen, 4032 Debrecen, Hungary
Author contributions: Fülöp T was the attending physician and initiated the concept of the paper; Gharaibeh KA and Craig MJ acquired data and drafted the manuscript; Lerant AA analyzed the data and revised the manuscript; Koch CA and Csongrádi É interpreted the data and critically revised the manuscript; all authors reviewed and approved the final manuscript.
Correspondence to: Kamel A Gharaibeh, MD, Department of Internal Medicine, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216-4505, United States. kgharaibeh@umc.edu
Telephone: +1-601-5002931 Fax: +1-601-5002931
Received: March 11, 2013
Revised: April 19, 2013
Accepted: May 18, 2013
Published online: August 16, 2013
Revised: April 19, 2013
Accepted: May 18, 2013
Published online: August 16, 2013
Core Tip
Core tip: In euvolemic hyponatremic patients, controlling the underlying reason of excessive vasopressin secretion may lead to sudden, large-volume free water diuresis and rise of serum sodium exceeding 12 mmol/L per day. Polyuria after presentation with symptomatic hyponatremia is a serious warning sign and should not be ignored. These patients need frequent electrolyte monitoring and, in case of excessive rise of serum sodium, pure water replacement with 5% dextrose in water to achieve a targeted reduction in serum sodium levels. Early addition of an antidiuretic hormone analog, such as desmopressin, can limit urine output and improve patient outcome.