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Management Strategies and Outcomes for Hyponatremia in Cirrhosis in the Hyponatremia Registry.

ABSTRACT: Aim:Treatment practices and effectiveness in cirrhotic patients with hyponatremia (HN) in the HN Registry were assessed. Methods:Characteristics, treatments, and outcomes were compared between patients with HN at admission and during hospitalization. For HN at admission, serum sodium concentration [Na] response was analyzed until correction to > 130?mmol/L, switch to secondary therapy, or discharge or death with sodium ? 130?mmol/L. Results:Patients with HN at admission had a lower [Na] and shorter length of stay (LOS) than those who developed HN (P < 0.001). Most common initial treatments were isotonic saline (NS, 36%), fluid restriction (FR, 33%), and no specific therapy (NST, 20%). Baseline [Na] was higher in patients treated with NST, FR, or NS versus hypertonic saline (HS) and tolvaptan (Tol) (P < 0.05). Treatment success occurred in 39%, 39%, 52%, 78%, and 81% of patients with NST, FR, NS, HS, and Tol, respectively. Relapse occurred in 55% after correction and was associated with increased LOS (9 versus 6 days, P < 0.001). 34% admitted with HN were discharged with HN corrected. Conclusions:Treatment approaches for HN were variable and frequently ineffective. Success was greatest with HS and Tol. Relapse of HN is associated with increased LOS.

SUBMITTER: Sigal SH

PROVIDER: S-EPMC6180997 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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Management Strategies and Outcomes for Hyponatremia in Cirrhosis in the Hyponatremia Registry.

Sigal Samuel H SH Amin Alpesh A Chiodo Joseph A JA Sanyal Arun A

Canadian journal of gastroenterology & hepatology 20180927

<h4>Aim</h4>Treatment practices and effectiveness in cirrhotic patients with hyponatremia (HN) in the HN Registry were assessed.<h4>Methods</h4>Characteristics, treatments, and outcomes were compared between patients with HN at admission and during hospitalization. For HN at admission, serum sodium concentration [Na] response was analyzed until correction to > 130 mmol/L, switch to secondary therapy, or discharge or death with sodium ≤ 130 mmol/L.<h4>Results</h4>Patients with HN at admission had ...[more]

PMID: 30363747

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Management Strategies and Outcomes for Hyponatremia in Cirrhosis in the Hyponatremia Registry.

Publications

Management Strategies and Outcomes for Hyponatremia in Cirrhosis in the Hyponatremia Registry.

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