Management Strategies and Outcomes for Hyponatremia in Cirrhosis in the Hyponatremia Registry
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...
Saved in:
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2018-01-01
|
| Series: | Canadian Journal of Gastroenterology and Hepatology |
| Online Access: | http://dx.doi.org/10.1155/2018/1579508 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832547463948402688 |
|---|---|
| author | Samuel H. Sigal Alpesh Amin Joseph A. Chiodo Arun Sanyal |
| author_facet | Samuel H. Sigal Alpesh Amin Joseph A. Chiodo Arun Sanyal |
| author_sort | Samuel H. Sigal |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-ca46a5514115425aa8c6bc4ac8315fe8 |
| institution | Kabale University |
| issn | 2291-2789 2291-2797 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Canadian Journal of Gastroenterology and Hepatology |
| spelling | doaj-art-ca46a5514115425aa8c6bc4ac8315fe82025-02-03T06:44:47ZengWileyCanadian Journal of Gastroenterology and Hepatology2291-27892291-27972018-01-01201810.1155/2018/15795081579508Management Strategies and Outcomes for Hyponatremia in Cirrhosis in the Hyponatremia RegistrySamuel H. Sigal0Alpesh Amin1Joseph A. Chiodo2Arun Sanyal3Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York 10467, USADepartment of Medicine, University of California, Irvine, California 92868, USAAgile Therapeutics, Inc., Princeton, New Jersey 08540, USAVirginia Commonwealth University Medical Center, Richmond, Virginia 23298, USAAim. 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.http://dx.doi.org/10.1155/2018/1579508 |
| spellingShingle | Samuel H. Sigal Alpesh Amin Joseph A. Chiodo Arun Sanyal Management Strategies and Outcomes for Hyponatremia in Cirrhosis in the Hyponatremia Registry Canadian Journal of Gastroenterology and Hepatology |
| title | Management Strategies and Outcomes for Hyponatremia in Cirrhosis in the Hyponatremia Registry |
| title_full | Management Strategies and Outcomes for Hyponatremia in Cirrhosis in the Hyponatremia Registry |
| title_fullStr | Management Strategies and Outcomes for Hyponatremia in Cirrhosis in the Hyponatremia Registry |
| title_full_unstemmed | Management Strategies and Outcomes for Hyponatremia in Cirrhosis in the Hyponatremia Registry |
| title_short | Management Strategies and Outcomes for Hyponatremia in Cirrhosis in the Hyponatremia Registry |
| title_sort | management strategies and outcomes for hyponatremia in cirrhosis in the hyponatremia registry |
| url | http://dx.doi.org/10.1155/2018/1579508 |
| work_keys_str_mv | AT samuelhsigal managementstrategiesandoutcomesforhyponatremiaincirrhosisinthehyponatremiaregistry AT alpeshamin managementstrategiesandoutcomesforhyponatremiaincirrhosisinthehyponatremiaregistry AT josephachiodo managementstrategiesandoutcomesforhyponatremiaincirrhosisinthehyponatremiaregistry AT arunsanyal managementstrategiesandoutcomesforhyponatremiaincirrhosisinthehyponatremiaregistry |