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Previous Volume 356:2064-2072 May 17, 2007 Number 20 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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This Journal feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the authors' clinical recommendations.

A 62-year-old woman noted an unpleasant, sweet taste in her mouth. She otherwise felt well and was taking no medications. Because dysgeusia is a rare manifestation of hyponatremia, her serum sodium level was tested and was 122 mmol per liter. The serum osmolality was 250 mOsm per kilogram of water, the urinary osmolality 635 mOsm per kilogram of water, the urinary sodium . . . [Full Text of this Article]

The Clinical Problem

Strategies and Evidence

Diagnosis

Management

            Acute Symptomatic Hyponatremia

            Hyponatremia of Long or Unclear Duration

            Vasopressin-Receptor Antagonist Therapy

Areas of Uncertainty

Optimal Strategies for Correcting Serum Sodium Levels

Osmotic Demyelination

Cerebral Salt Wasting

Prevention of Postoperative Hyponatremia

Guidelines from Professional Societies

Summary and Recommendations

Source Information

From the Division of Nephrology and Hypertension and the Department of Physiology and Pharmacology, Oregon Health and Science University and Veterans Affairs Medical Center, Portland, OR (D.H.E.); and the Division of Renal Diseases and Hypertension, University of Colorado Health Sciences Center, Denver (T.B.).

Address reprint requests to Dr. Ellison at the Division of Nephrology and Hypertension, Oregon Health and Science University, PP262, 3314 SW U.S. Veterans Hospital Rd., Portland, OR 97239, or at ellisond@ohsu.edu.

Related Letters:

The Syndrome of Inappropriate Antidiuresis
Lowance D. C., Moritz M. L., Ayus J. C., Ellison D. H., Berl T.
Extract | Full Text | PDF  
N Engl J Med 2007; 357:941-942, Aug 30, 2007. Correspondence

This article has been cited by other articles:

• Soule, S., Florkowski, C., Potter, H., Pattison, D., Swan, M., Hunt, P., George, P. (2008). Intermittent severe, symptomatic hyponatraemia due to the nephrogenic syndrome of inappropriate antidiuresis. Ann Clin Biochem 45: 520-523 [Abstract] [Full Text]  
• Decaux, G., Musch, W. (2008). Clinical Laboratory Evaluation of the Syndrome of Inappropriate Secretion of Antidiuretic Hormone. CJASN 3: 1175-1184 [Abstract] [Full Text]  
• Madewell, K. A., Kuo, P. (2008). Hyponatremia associated with tolterodine therapy. Am J Health Syst Pharm 65: 1054-1056 [Abstract] [Full Text]  
• Berl, T. (2008). Impact of Solute Intake on Urine Flow and Water Excretion. J. Am. Soc. Nephrol. 19: 1076-1078 [Abstract] [Full Text]  
• Berl, T. (2007). The Adrogue-Madias Formula Revisited. CJASN 2: 1098-1099 [Full Text]  
• Lowance, D. C., Moritz, M. L., Ayus, J. C., Ellison, D. H., Berl, T. (2007). The Syndrome of Inappropriate Antidiuresis. NEJM 357: 941-942 [Full Text]