Korean J Intern Med.
2022 Nov;37(6):1120-1137. 10.3904/kjim.2022.174.
Korean Society of Nephrology 2022 recommendations on controversial issues in diagnosis and management of hyponatremia
- Affiliations
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- 1Division of Nephrology, Department of Internal Medicine, Uijeongbu Eulji Medical Center, Eulji University, Uijeongbu, Korea
- 2Division of Nephrology, Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
- 3Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea
- 4Division of Nephrology, Department of Internal Medicine, College of Medicine, Kyung Hee University, Seoul, Korea
- 5Division of Nephrology, Department of Internal Medicine, Pusan National University Hospital, Busan, Korea
- 6Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea
- 7Division of Nephrology, Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Korea
- 8Division of Nephrology, Department of Internal Medicine, Korea University Anam Hospital, Seoul, Korea
- 9Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea
- 10Division of Nephrology, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
- 11Division of Pediatric Nephrology, Department of Pediatrics, Bucheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Korea
- 12Division of Pediatric Nephrology, Department of Pediatrics, Chonnam National University Hospital, Gwangju, Korea
- 13Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
- 14Department of Biostatistics, Korea University College of Medicine, Seoul, Korea
- 15Division for Healthcare Technology Assessment Research, National Evidence-Based Healthcare Collaborating Agency (NECA), Seoul, Korea
- 16Division of Nephrology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
- 17Division of Nephrology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- KMID: 2535978
- DOI: http://doi.org/10.3904/kjim.2022.174
Abstract
- The Korean Society for Electrolyte and Blood Pressure Research, in collaboration with the Korean Society of Nephrology, has published a clinical practice guideline (CPG) document for hyponatremia treatment. The document is based on an extensive evidence-based review of the diagnosis, evaluation, and treatment of hyponatremia with the multidisciplinary participation of representative experts in hyponatremia with methodologist support for guideline development. This CPG consists of 12 recommendations (two for diagnosis, eight for treatment, and two for special situations) based on eight detailed topics and nine key questions. Each recommendation begins with statements graded by the strength of the recommendations and the quality of the evidence. Each statement is followed by rationale supporting the recommendations. The committee issued conditional recommendations in favor of rapid intermittent bolus administration of hypertonic saline in severe hyponatremia, the use of vasopressin receptor antagonists in heart failure with hypervolemic hyponatremia, and syndrome of inappropriate antidiuresis with moderate to severe hyponatremia, the individualization of desmopressin use, and strong recommendation on the administration of isotonic fluids as maintenance fluid therapy in hospitalized pediatric patients. We hope that this CPG will provide useful recommendations in practice, with the aim of providing clinical support for shared decision-making to improve patient outcomes.
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