Abstract
Rapid correction of chronic hyponatremia (CH) may lead to the development of osmotic myelinolysis (OM), a condition with high mortality and high incidence of devastating neurological sequelae. Treatment guidelines suggest “safe” overall rates of correction of serum sodium concentration ([Na] s ) over the first 24 and 48 hours of treatment of CH. We report a patient with CH who developed fatal OM despite overall rates of correction of [Na] s that were within the recommended rates. The potential risk factors for the development of OM in this patient included short (within a few hours) rises in [Na] s exceeding 0.5 mmol/l per hour and the presence of severe protein malnutrition. We suggest that the rate of correction of [Na] s in CH should be uniformly slow and that the overall rate of correction should be slower than the currently recommended rate in severely malnourished patients.
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Dellabarca, C., Servilla, K.S., Hart, B. et al. Osmotic Myelinolysis Following Chronic Hyponatremia Corrected at An Overall Rate Consistent with Current Recommendations. Int Urol Nephrol 37, 171–173 (2005). https://doi.org/10.1007/s11255-004-4770-9
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DOI: https://doi.org/10.1007/s11255-004-4770-9