Management Strategies and Outcomes for Hyponatremia in Cirrhosis in the Hyponatremia Registry. (27th September 2018)

• Record Type: Journal Article
• Authors: Sigal, Samuel H.; Amin, Alpesh; Chiodo, Joseph A.; Sanyal, Arun
• Other Names: Chen En-Qiang Academic Editor.
• Is Part Of: Canadian journal of gastroenterology & hepatology. Volume 2018(2018)
• Publication Date: 2018-09-27
• Subjects: Digestive organs -- Diseases -- Periodicals; Gastroenterology -- Periodicals; Digestive organs -- Diseases; Gastroenterology; Canada; Digestive System Diseases -- Periodicals; Gastroenterology -- Periodicals; Periodicals; Electronic journals; Fulltext; Internet Resources; Periodicals; 616.3
• DOI: 10.1155/2018/1579508
• Languages: English
• ISSNs: 2291-2789

Abstract

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.