Management of Sodium Imbalance

Authors

  • Barkah Djaka Purwanto Universitas Ahmad Dahlan
  • Rachma Greta Perdana Putri Universitas Ahmad Dahlan, Yogyakarta, Indonesia

Abstract

Sodium imbalance consists of hyponatremia and hypernatremia. Acute and severe hyponatremia and hypernatremia are life-threatening conditions. Rapid and slow correction should be considered for optimal outcomes, as aggressive management is often associated with the danger of demyelination and cerebral edema. This review aims to determine the safe management of sodium imbalance so that it is hoped that in overcoming critical conditions it does not transfer to other critical conditions that are equally fatal. The data search strategy uses the PubMed and Google Scholar databases between 2010 and 2022 with free full text that can be downloaded. The findings emphasize that acute and severe hyponatremia and hypernatremia are often life-threatening conditions. Management of these conditions requires caution, as aggressive correction in hyponatremia can result in osmotic demyelination, while hypernatremia can lead to cerebral edema. Despite theoretical risks, the study found no significant difference in 30-day mortality, seizures, cerebral edema, or decreased consciousness between fast and slow correction methods. The conclusion underscores the importance of tailored and cautious management strategies to mitigate the risks associated with sodium imbalance corrections.

References

Hao et al, 2017. The prevalence and mortality of hyponatremia is seriously underestimated in Chinese general medical patients: an observational retrospective study BMC Nephrol. 18: 328

Semenovskaya, 2022. Hypernatremia in Emergency Medicine. Medscape

Sterns, R.H., 2015. Evidence for Managing Hypernatremia Is It Just Hyponatremia in Reverse? N Engl J Med. 372:55-65.

Hoorn EJ, Zietse R., 2017. Diagnosis and treatment of hyponatremia: Compilation of the guidelines. JASN ;28:1340-1349

Hamrahian, S.M., 2022. Hyponatremia Treatment & Management. Medscape

Vaidya et al 2010. Management of Hyponatremia: Providing Treatment and Avoiding Harm. Cleveland Clinic Journal of Medicine volume 77 number 10 doi:10.3949/ccjm.77a.08051

Chauhan et al, 2019. Rate of Correction of Hypernatremia and Health Outcomes in Critically Ill Patients Clin J Am Soc Nephrol 14: 656–663, 2019. doi: https://doi.org/10.2215/CJN.10640918

Tsipotis E, Price LL, Jaber BL, Madias NE, 2018: Hospital-associated hypernatremia spectrum and clinical outcomes in an unselected cohort. Am J Med 131: 72–82.e1,

Lukitsch, 2021. Hypernatremia Treatment and management. Medscape

Seay et al., 2020. Diagnosis and Management of Disorders of Body Tonicity—Hyponatremia and Hypernatremia: Core Curriculum 2020. AJKD Vol 75 | Iss 2 | February

Tinawi, M., 2020. Hyponatremia and Hypernatremia: A Practical Guide to Disorders of Water Balance Arch Intern Med Res; 3 (1): 074-095 DOI: 10.26502/aimr.0025

Arzhan S, Lew SQ, Ing TS, Tzamaloukas AH, Unruh ML. Dysnatremias in Chronic Kidney Disease: Pathophysiology, Manifestations, and Treatment. Front Med (Lausanne). 2021 Dec 6;8:769287. doi: 10.3389/fmed.2021.769287. PMID: 34938749; PMCID: PMC8687113

Yun G, Baek SH, Kim S. Evaluation and management of hypernatremia in adults: clinical perspectives. Korean J Intern Med. 2023 May;38(3):290-302. doi: 10.3904/kjim.2022.346. Epub 2022 Dec 29. PMID: 36578134; PMCID: PMC10175862.

Lindner G, Schwarz C, Haidinger M, Ravioli S. Hyponatremia in the emergency department. Am J Emerg Med. 2022 Oct;60:1-8. doi: 10.1016/j.ajem.2022.07.023. Epub 2022 Jul 19. PMID: 35870366.

Adrogué HJ, Tucker BM, Madias NE. Diagnosis and Management of Hyponatremia: A Review. JAMA. 2022;328(3):280–291. doi:10.1001/jama.2022.11176

Kheetan M, Ogu I, Shapiro JI, Khitan ZJ. Acute and Chronic Hyponatremia. Front Med (Lausanne). 2021 Aug 3;8:693738. doi: 10.3389/fmed.2021.693738. PMID: 34414205; PMCID: PMC8369240.

Downloads

Published

2024-08-03

How to Cite

Purwanto, B. D., & Perdana Putri, R. G. (2024). Management of Sodium Imbalance. Ahmad Dahlan Medical Journal, 5(1), 77–88. Retrieved from http://journal2.uad.ac.id/index.php/admj/article/view/10332

Issue

Section

Articles

Most read articles by the same author(s)