Management Strategies and Outcomes for Hyponatremia in Cirrhosis in the Hyponatremia Registry.
Can J Gastroenterol Hepatol
; 2018: 1579508, 2018.
Article
em En
| MEDLINE
| ID: mdl-30363747
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.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Sódio
/
Antidiuréticos
/
Hiponatremia
/
Soluções Isotônicas
/
Cirrose Hepática
Tipo de estudo:
Etiology_studies
/
Evaluation_studies
Limite:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Can J Gastroenterol Hepatol
Ano de publicação:
2018
Tipo de documento:
Article
País de afiliação:
Estados Unidos