Severe chronic hyponatremia should be corrected with caution and slowly,
with less than 0.3 - 0.5 mmol/hr or 25 mmol in the first two days, for
instance by fluid restriction.
Acute hyponatremia may be corrected more aggressively, i.e. with 514 mmol/l
NaCl.
See:
Gross P, Kidney Int Suppl 1998, 64: S6 - S11.
Oh MS, Nephron 1995, 70: 143 - 50.
Maurits Pekelharing
----- Original Message -----
From: Mohammad Al-Jubouri <[log in to unmask]>
To: R.W. Wulkan <[log in to unmask]>;
<[log in to unmask]>
Sent: Monday, October 09, 2000 6:31 PM
Subject: Re: Extreme hyponatremia
> Osmotic demeylination syndromes such as central
> pontine meylinolysis (CPM) has been described mainly
> in malnourished chronically hyponatraemic patients in
> whom active rapid correction to normonatraemia was
> achieved by hypertonic saline.
>
> regards.
>
> --- "R.W. Wulkan" <[log in to unmask]>
> wrote: > This week we had an interesting patient: a
> man (43
> > years) who had
> > the following results when admitted:
> >
> > Na 98 mmol/L
> >
> > Osmol 229 mmol/L
> > Urea 1.8 mmol/L
> > Cortisol 1.36 umol/L
> > UrOsmol 145 mosmol/L
> >
> > His Sodium rose to 123 mmol/L within 12 hours, which
> > prompted
> > me to ask why the correction was made that rapidly.
> > Apparently the patient did all the correction for
> > himself. Suffering
> > from psychogenic polydipsia and submitted to water
> > restriction he
> > produced an urine volume of 10 L and thus caused the
> > quick rise of
> > the sodium level. No neurologic side effects.
> >
> > Raymond Wulkan
> >
>
>
> =====
> Dr. M A Al-Jubouri
> Consultant Chemical Pathologist
> Whiston Hospital
> Prescot
> Merseyside L35 5DR
> UK
>
> __________________________________________________
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