This Journal feature begins with a case vignette highlightinga common clinical problem. Evidence supporting various strategiesis then presented, followed by a review of formal guidelines,when they exist. The article ends with the authors' clinicalrecommendations.
A 62-year-old woman noted an unpleasant, sweet taste in hermouth. She otherwise felt well and was taking no medications.Because dysgeusia is a rare manifestation of hyponatremia, herserum sodium level was tested and was 122 mmol per liter. Theserum osmolality was 250 mOsm per kilogram of water, the urinaryosmolality 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.
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