Yıl: 2015 Cilt: 24 Sayı: 2 Sayfa Aralığı: 148 - 157 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Güncel Gelişmeler Işığında Hiponatremi ve Yönetimi

Öz:
En sık izlenen elektrolit bozukluğu olan hiponatremi, sodyum ve su arasındaki mükemmel dengenin birçok farklı nedene bağlı olarak bozulması sonucu gelişebilmektedir. Hiponatremi tanı ve tedavisinde bu faktörlerin tespiti önemlidir. Hiponatremi ile ilişkili belirtiler çoğunlukla hiponatreminin gelişme hızı ve derinliğine bağlıdır. Akut hiponatremiye bağlı gelişen beyin ödemi ve kronik hiponatreminin hızlı düzeltilmesine bağlı gelişen osmotik demiyelinasyon artmış ölüm riskine neden olmaktadır. Bu nedenle uygun olmayan tedavi yaklaşımları morbidite ve mortalitede artışa yol açabilir. Yakın zamanda hiponatremi tanı ve tedavisi ile ilgili yeni kılavuz ve uzman görüşleri yayınlanmıştır. Ancak önerilerle ilgili tartışmalar hala sürmektedir. Biz bu derlemede, hiponatremi ile ilgili güncel gelişmeleri özetledik ve hiponatremi yönetimindeki farklı yaklaşımları tartıştık.
Anahtar Kelime:

Konular: Cerrahi

Recent Developments in Hyponatremia and Its Management

Öz:
Abstract Hyponatremia is the most common electrolyte disorder and can develop due to many different reasons disrupting the perfect balance of sodium and water. Determination of these factors is important in the diagnosis and treatment of hyponatremia. Symptoms of hyponatremia depend mostly on the rate of development. Brain edema due to acute hyponatremia and osmotic demyelination due to rapid correction of chronic hyponatremia can cause an increased risk of death. Inappropriate therapeutic approaches can therefore lead to an increase in morbidity and mortality. New guidelines about the diagnosis and treatment of hyponatremia have been published recently. However, there is controversy regarding some of these recommendations. In this review, we summarize the current literature on hyponatremia and discuss the different approaches in hyponatremia management. Key words: Hyponatremia, Guidelines, Sodium
Anahtar Kelime:

Konular: Cerrahi
Belge Türü: Makale Makale Türü: Derleme Erişim Türü: Erişime Açık
  • 1. Despopoulos A, Silbernagl S: Color atlas of physiology. Kidney, Salt and Water Balance, 5th ed. Stuttgart: Thieme, 2003;168-171
  • 2. Eaton DC, Pooler JP: Vander’s Renal Physiology (7th ed). New York: McGraw Hill Medical, 2009; 103-104
  • 3. Ivy JR, Bailey MA: Pressure natriuresis and the renal control of arterial blood pressure. J Physiol 2014;592:3955-3967
  • 4. Choi MR, Rukavina Mikusic NL, Kouyoumdzian NM, Kravetz MC, Fernández BE: Atrial natriuretic peptide and renal dopaminergic system: A positive friendly relationship? Biomed Res Int 2014;2014:710781
  • 5. Granger JP, Alexander BT, Llinas M: Mechanisms of pressure natriuresis. Curr Hypertens Rep 2002;4(2):152-159
  • 6. Ren Y, D’Ambrosio MA, Garvin JL, Leung P, Kutskill K, Wang H, Peterson EL, Carretero OA: Aldosterone sensitizes connecting tubule glomerular feedback via the aldosterone receptor GPR30. Am J Physiol Renal Physiol 2014;307(4):F427-434
  • 7. Danziger J, Zeidel ML: Osmotic homeostasis. Clin J Am Soc Nephrol 2014. pii: CJN.10741013. [Epub ahead of print]
  • 8. Luckey AE, Parsa CJ: Fluid and electrolytes in the aged. Arch Surg 2003;138:1055-1060
  • 9. Kugler JP, Hustead T: Hyponatremia and hypernatremia in the elderly. Am Fam Physician 2000;61:3623-3630
  • 10. Turgutalp K, Ozhan O, Oguz EG, Horoz M, Camsari A, Yilmaz A, Kiykim A, Arici M: Clinical features, outcome and cost of hyponatremia associated admission and hospitalization in elderly and very elderly patients: A single-center experience in Turkey. Int Urol Nephrol 2013;45:265-273
  • 11. Rodenburg EM, Hoorn EJ, Ruiter R, Lous JJ, Hofman A, Uitterlinden AG, Stricker BH, Visser LE: Thiazide-associated hyponatremia: A population-based study. Am J Kidney Dis 2013;62(1):67-72
  • 12. Sharabi Y, Illan R, Kamari Y, Cohen H, Nadler M, Messerli FH, Grossman E: Diuretic induced hyponatraemia in elderly hypertensive women. J Hum Hypertens 2002;16(9):631-635
  • 13. Upadhyay A, Jaber BL, Madias NE: Epidemiology of hyponatremia. Semin Nephrol 2009;29(3):227-238
  • 14. Laczi F: Etiology, diagnostics and therapy of hyponatremias. Orv Hetil 2008;149(29):1347-1354
  • 15. Spasovski G, Vanholder R, Allolio B, Annane D, Ball S, Bichet D, Decaux G, Fenske W, Hoorn EJ, Ichai C, Joannidis M, Soupart A, Zietse R, Haller M, van der Veer S, Van Biesen W, Nagler E; Hyponatraemia Guideline Development Group: Clinical practice guideline on diagnosis and treatment of hyponatraemia. Nephrol Dial Transplant 2014;29 Suppl 2: 1-39
  • 16. Verbalis JG, Goldsmith SR, Greenberg A, Korzelius C, Schrier RW, Sterns RH, Thompson CJ: Diagnosis, evaluation, and treatment of hyponatremia: Expert panel recommendations. Am J Med 2013;126(10 Suppl 1):S1-42
  • 17. Bettari L, Fiuzat M, Shaw LK, Wojdyla DM, Metra M, Felker GM, O’Connor CM: Hyponatremia and long-term outcomes in chronic heart failure-an observational study from the Duke Databank for Cardiovascular Diseases. J Card Fail 2012;18(1):74-81
  • 18. Angeli P, Wong F, Watson H, Ginès P; CAPPS Investigators: Hyponatremia in cirrhosis: Results of a patient population survey. Hepatology 2006;44(6):1535-1542
  • 19. Hawkins RC: Age and gender as risk factors for hyponatremia and hypernatremia. Clin Chim Acta 2003;337:169-172
  • 20. Decaux G, Soupart A: Treatment of symptomatic hyponatremia. Am J Med Sci 2003;326(1):25-30
  • 21. Floege J, Johnson RJ, Feehally J: Comphrensive Clinical Nephrology (4th ed). Philadelphia: Elsevier Saunders, 2010; 100-117
  • 22. Berendes E, Walter M, Cullen P, Prien T, Van Aken H, Horsthemke J, Schulte M, von Wild K, Scherer R: Secretion of brain natriuretic peptide in patients with aneurysmal subarachnoid haemorrhage. Lancet 1997;349(9047):245-249
  • 23. Hamdi T, Latta S, Jallad B, Kheir F, Alhosaini MN, Patel A: Cisplatin-induced renal salt wasting syndrome. South Med J 2010;103(8):793-799
  • 24. Yeates KE, Singer M, Morton AR: Salt and water: A simple approach to hyponatremia. CMAJ 2004; 170(3):365-369
  • 25. Gradden CW, Ahmad R, Bell GM: Peritoneal dialysis: New developments and new problems. Diabet Med 2001;18(5):360-363
  • 26. Turchin A, Seifter JL, Seely EW: Clinical problem-solving. Mind the gap. N Engl J Med 2003;349:1465-1469
  • 27. Reddy P, Mooradian AD: Diagnosis and management of hyponatraemia in hospitalised patients. Int J Clin Pract 2009;63(10):1494-1508
  • 28. Ahamed S, Anpalahan M, Savvas S, Gibson S, Torres J, Janus E: Hyponatraemia in older medical patients: Implications for falls and adverse outcomes of hospitalisation. Intern Med J 2014;44(10):991- 997
  • 29. Gankam Kengne F1, Andres C, Sattar L, Melot C, Decaux G: Mild hyponatremia and risk of fracture in the ambulatory elderly. QJM 2008;101:583-588
  • 30. Verbalis JG, Barsony J, Sugimura Y, Tian Y, Adams DJ, Carter EA, Resnick HE: Hyponatremia-Induced Osteoporosis. J Bone Miner Res 2010;25(3):554-563
  • 31. Moritz ML, Ayus JC: The pathophysiology and treatment of hyponatraemic encephalopathy: An update. Nephrol Dial Transplant 2003;18:2486-2491
  • 32. Arieff AI: Influence of hypoxia and sex on hyponatremic encephalopathy. Am J Med 2006;119(7 Suppl 1):S59-64
  • 33. Ayus JC, Wheeler JM, Arieff AI: Postoperative hyponatremic encephalopathy in menstruant women. Ann Intern Med 1992;117(11):891-897
  • 34. Harring TR, Deal NS, Kuo DC: Disorders of sodium and water balance. Emerg Med Clin N Am 2014;32:379-401
  • 35. Widdess-Walsh P, Sabharwal V, Demirjian S, DeGeorgia M: Neurologic effects of hyponatremia and its treatment. Cleve Clin J Med 2007;74(5):377-383
  • 36. Lien YH, Shapiro JI, Chan L: Study of brain electrolytes and organic osmolytes during correction of chronic hyponatremia implications for the pathogenesis of central pontine myelinolysis. J Clin Invest 1991;88: 303-309
  • 37. Martin RJ: Central pontine and extrapontine myelinolysis: The osmotic demyelination syndromes. J Neurol Neurosurg Psychiatry 2004;75(III):iii22-28
  • 38. Sterns RH, Silver SM: Brain volume regulation in response to hypo- osmolality and its correction. Am J Med 2006;119(7 Suppl 1):S12- 16
  • 39. Bibl D, Lampl C, Gabriel C, Jüngling G, Brock H, Köstler G: Treatment of central pontine myelinolysis with therapeutic plasmapheresis. Lancet 1999;353:1155
  • 40. Sterns RH, Hix JK: Overcorrection of hyponatremia is a medical emergency. Kidney Int 2009;76:587-589
  • 41. Liamis G, Rodenburg EM, Hofman A, Zietse R, Stricker BH, Hoorn EJ: Electrolyte disorders in community subjects: Prevalence and risk factors. Am J Med 2013;126:256-263
  • 42. Hoorn EJ, Zietse R: Hyponatremia and mortality: Moving beyond associations. Am J Kidney Dis 2013;62(1):139-149
  • 43. Gefen S, Joffe E, Mayana H, Justo D: Recurrent hospitalizations with moderate to severe hyponatremia in older adults and its associated mortality. Eur J Intern Med 2014;25(7):624-628
  • 44. Miller M: Hyponatremia and arginine vasopressin dysregulation: Mechanisms, clinical consequences, and management. J Am Geriatr Soc 2006;54(2):345-353
  • 45. Hoorn EJ, Halperin ML, Zietse R: Diagnostic approach to a patient with hyponatraemia: Traditional versus physiology-based options. QJM 2005;98:529-540
  • 46. Vaidya C, Warren HO, Freda BJ: Management of hyponatremia: Providing treatment and avoiding harm. Cleve Clin J Med 2010;77:715-726
  • 47. Zietse R, Zoutendijk R, Hoorn EJ: Fluid, electrolyte and acid- base disorders associated with antibiotic therapy. Nat Rev Nephrol 2009;5(4):193-202
  • 48. Fadel S, Karmali R, Cogan E: Safety of furosemide administration in an elderly woman recovered from thiazide-induced hyponatremia. Eur J Intern Med 2009;20(1):30-34
  • 49. Fichman MP, Vorherr H, Kleeman CR, Telfer N: Diuretic-induced hyponatremia. Ann Intern Med 1971;75(6):853-863
  • 50. van Blijderveen JC, Straus SM, Rodenburg EM, Zietse R, Stricker BH, Sturkenboom MC, Verhamme KM: Risk of hyponatremia with diuretics: Chlorthalidone versus hydrochlorothiazide. Am J Med 2014;127(8):763-771
  • 51. Sonnenblick M, Friedlander Y, Rosin AJ: Diuretic-induced severe hyponatremia. Review and analysis of 129 reported patients. Chest 1993;103(2):601-606
  • 52. Goland S, Naugolny V, Korbut Z, Rozen I, Caspi A, Malnick S: Appropriateness and complications of the use of spironolactone in patients treated in a heart failure clinic. Eur J Intern Med 2011;22:424-427
  • 53. Castillo J, Vincent M, Justice E: Diagnosis and management of hyponatremia in cancer patients. Oncologist 2012;17:756-765
  • 54. Liamis G, Rodenburg EM, Hofman A, Zietse R, Stricker BH, Hoorn EJ: Electrolyte disorders in community subjects: Prevalence and risk factors. Am J Med 2013;126(3):256-263
  • 55. Gefen S, Joffe E, Mayan H, Justo D: Recurrent hospitalizations with moderate to severe hyponatremia in older adults and its associated mortality. Eur J Intern Med 2014;25:624-628
  • 56. Mohan S, Gu S, Parikh A, Radhakrishnan J: Prevalence of hyponatremia and association with mortality: Results from NHANES. Am J Med 2013;126(12):1127-1137
  • 57. Moritz ML, Ayus JC: Management of hyponatremia in various clinical situations. Curr Treat Options Neurol 2014;16(9):310
  • 58. Vasudev NS, Brown JE, Brown SR, Rafiq R, Morgan R, Patel PM, O’Donnell D, Harnden P, Rogers M, Cocks K, Anderson K, Paul A, Eardley I, Selby PJ, Banks RE: Prognostic factors in renal cell carcinoma: Association of preoperative sodium concentration with survival. Clin Cancer Res 2008;14(6):1775-1781
  • 59. Dhaliwal HS, Rohatiner AZS, Gregory W, Richards MA, Johnson PWM, Whelan JS, Gallagher CJ, Matthews J, Ganesan TS, Barnett MJ, Waxman JH, Stansfeld AG, Wrigley PFM, Slevin ML, Malpas JS, Lister TA: Combination chemotherapy for intermediate and high grade non-Hodgkin’s lymphoma. Br J Cancer 1993;68(4):767-774
  • 60. Waikar SS, Mount DB, Curhan GC: Mortality after hospitalization with mild, moderate and severe hyponatremia. Am J Med 2009;122(9):857-865
  • 61. Hermes A, Waschki B, Reck M: Hyponatremia as prognostic factor in small cell lung cancer-a retrospective single institution analysis. Respir Med 2012;106(6):900-904
  • 62. Rosner MH, Dalkin AC: Electrolyte disorders associated with cancer. Adv Chronic Kidney Dis 2014;21(1):7-17
  • 63. Ferlito A, Rinaldo A, Devaney KO: Syndrome of inappropriate antidiuretic hormone secretion associated with head and neck cancers: Review of the literature. Ann Otol Rhinol Laryngol 1997;106: 878-883
  • 64. Raftopoulos H: Diagnosis and management of hyponatremia in cancer patients. Support Care Cancer 2007;15:1341-1347
  • 65. Noakes TD, Goodwin N, Rayner BL, Branken T, Taylor RK: Water intoxication: A possible complication during endurance exercise. Med Sci Sports Exerc 1985;17:370-375
  • 66. Hew-Butler T, Ayus JC, Kipps C, Maughan RJ, Mettler S, Meeuwisse WH, Page AJ, Reid SA, Rehrer NJ, Roberts WO, Rogers IR, Rosner MH, Siegel AJ, Speedy DB, Stuempfle KJ, Verbalis JG, Weschler LB, Wharam P: Statement of the Second International Exercise- Associated Hyponatremia Consensus Development Conference, New Zealand, 2007. Clin J Sport Med 2008;18:111-121
  • 67. Bennett BL, Hew-Butler T, Hoffman MD, Rogers IR, Rosner MH; Wilderness Medical Society: Wilderness Medical Society practice guidelines for treatment of exercise-associated hyponatremia. Wilderness Environ Med 2013;24(3):228-240
  • 68. Ayus JC, Moritz ML: Exercise-associated hyponatremia masquerading as acute mountain sickness: Are we missing the diagnosis? Clin J Sport Med 2008;18:383-386
  • 69. Davis DP, Videen JS, Marino A, Vilke GM, Dunford JV, Van Camp SP, Maharam LG. Exercise-associated hyponatremia in marathon runners: A two-year experience. J Emerg Med 2001;21:47-57
  • 70. Corona G, Simonetti L, Giuliani C, Sforza A, Peri A: A case of osmotic demyelination syndrome occurred after the correction of severe hyponatraemia in hyperemesis gravidarum. BMC Endocr Disord 2014;14:34
  • 71. Rondon-Berrios H, Agaba EI, Tzamaloukas AH: Hyponatremia: Pathophysiology, classification, manifestations and management. Int Urol Nephrol 2014;46:2153-2165
  • 72. Berl T: Impact of solute intake on urine flow and water excretion. J Am Soc Nephrol 2008;19:1076-1078
  • 73. Rozen-Zvi B, Yahav D, Gheorghiade M, Korzets A, Leibovici L, Gafter U: Vasopressin receptor antagonists for the treatment of hyponatremia: Systematic review and meta-analysis. Am J Kidney Dis 2010;56(2):325-337
  • 74. Schrier RW, Gross P, Gheorghiade M, Berl T, Verbalis JG, Czerwiec FS, Orlandi C: Tolvaptan, a selective oral vasopressin V2-receptor antagonist, for hyponatremia. N Engl J Med 2006;355(20): 2099-2112
  • 75. Samsca (Tolvaptan): Drug Safety Communication - FDA limits duration and usage due to possible liver injury leading to organ transplant or death. http://www.fda.gov/Drugs/DrugSafety/ ucm350062.htm. Accessed April 30, 2013
  • 76. Verbalis JG, Grossman A, Höybye C, Runkle I: Review and analysis of differing regulatory indications and expert panel guidelines for the treatment of hyponatremia. Curr Med Res Opin 2014;30(7):1201- 1207
APA Bardak S, TURGUTALP K, Demir S, Kiykim A (2015). Güncel Gelişmeler Işığında Hiponatremi ve Yönetimi. , 148 - 157.
Chicago Bardak Simge,TURGUTALP Kenan,Demir Serap,Kiykim Ahmet Güncel Gelişmeler Işığında Hiponatremi ve Yönetimi. (2015): 148 - 157.
MLA Bardak Simge,TURGUTALP Kenan,Demir Serap,Kiykim Ahmet Güncel Gelişmeler Işığında Hiponatremi ve Yönetimi. , 2015, ss.148 - 157.
AMA Bardak S,TURGUTALP K,Demir S,Kiykim A Güncel Gelişmeler Işığında Hiponatremi ve Yönetimi. . 2015; 148 - 157.
Vancouver Bardak S,TURGUTALP K,Demir S,Kiykim A Güncel Gelişmeler Işığında Hiponatremi ve Yönetimi. . 2015; 148 - 157.
IEEE Bardak S,TURGUTALP K,Demir S,Kiykim A "Güncel Gelişmeler Işığında Hiponatremi ve Yönetimi." , ss.148 - 157, 2015.
ISNAD Bardak, Simge vd. "Güncel Gelişmeler Işığında Hiponatremi ve Yönetimi". (2015), 148-157.
APA Bardak S, TURGUTALP K, Demir S, Kiykim A (2015). Güncel Gelişmeler Işığında Hiponatremi ve Yönetimi. Türk Nefroloji Diyaliz ve Transplantasyon Dergisi, 24(2), 148 - 157.
Chicago Bardak Simge,TURGUTALP Kenan,Demir Serap,Kiykim Ahmet Güncel Gelişmeler Işığında Hiponatremi ve Yönetimi. Türk Nefroloji Diyaliz ve Transplantasyon Dergisi 24, no.2 (2015): 148 - 157.
MLA Bardak Simge,TURGUTALP Kenan,Demir Serap,Kiykim Ahmet Güncel Gelişmeler Işığında Hiponatremi ve Yönetimi. Türk Nefroloji Diyaliz ve Transplantasyon Dergisi, vol.24, no.2, 2015, ss.148 - 157.
AMA Bardak S,TURGUTALP K,Demir S,Kiykim A Güncel Gelişmeler Işığında Hiponatremi ve Yönetimi. Türk Nefroloji Diyaliz ve Transplantasyon Dergisi. 2015; 24(2): 148 - 157.
Vancouver Bardak S,TURGUTALP K,Demir S,Kiykim A Güncel Gelişmeler Işığında Hiponatremi ve Yönetimi. Türk Nefroloji Diyaliz ve Transplantasyon Dergisi. 2015; 24(2): 148 - 157.
IEEE Bardak S,TURGUTALP K,Demir S,Kiykim A "Güncel Gelişmeler Işığında Hiponatremi ve Yönetimi." Türk Nefroloji Diyaliz ve Transplantasyon Dergisi, 24, ss.148 - 157, 2015.
ISNAD Bardak, Simge vd. "Güncel Gelişmeler Işığında Hiponatremi ve Yönetimi". Türk Nefroloji Diyaliz ve Transplantasyon Dergisi 24/2 (2015), 148-157.