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低钠血症诊断与治疗临床实践指南

Hyponatraemia diagnosis and treatment clinical practice guidelines.

作者信息

Spasovski Goce, Vanholder Raymond, Allolio Bruno, Annane Djillali, Ball Steve, Bichet Daniel, Decaux Guy, Fenske Wiebke, Hoorn Ewout J, Ichai Carole, Joannidis Michael, Soupart Alain, Zietse Robert, Haller Maria, van der Veer Sabine, van Biesen Wim, Nagler Evi, Gonzalez-Espinoza Liliana, Ortiz Alberto

机构信息

State University Hospital Skopje, Skopie, Macedonia.

Ghent University Hospital, Ghent, Bélgica.

出版信息

Nefrologia. 2017 Jul-Aug;37(4):370-380. doi: 10.1016/j.nefro.2017.03.021. Epub 2017 Jun 12.

Abstract

Hyponatremia, defined as a serum sodium concentration <135mmol/l, is the most common water-electrolyte imbalance encountered in clinical practice. It can lead to a wide spectrum of clinical symptoms, from mild to severe or even life threatening, and is associated with increased mortality, morbidity and length of hospital stay. Despite this, the management of hyponatremia patients remains problematic. The prevalence of hyponatremia in a wide variety of conditions and the fact that hyponatremia is managed by clinicians with a broad variety of backgrounds have fostered diverse institution- and specialty-based approaches to diagnosis and treatment. To obtain a common and holistic view, the European Society of Intensive Care Medicine (ESICM), the European Society of Endocrinology (ESE) and the European Renal Association-European Dialysis and Transplant Association (ERA-EDTA), represented by European Renal Best Practice (ERBP), have developed clinical practice guidelines on the diagnostic approach and treatment of hyponatremia as a joint venture of 3societies representing specialists with a natural interest in hyponatremia. In addition to a rigorous approach to the methodology and evaluation of the evidence, the document focuses on patient-positive outcomes and on providing a useful tool for clinicians involved in everyday practice. In this article, we present an abridged version of the recommendations and suggestions for the diagnosis and treatment of hyponatremia extracted from the full guide.

摘要

低钠血症定义为血清钠浓度<135mmol/l,是临床实践中最常见的水电解质失衡。它可导致从轻度到重度甚至危及生命的一系列临床症状,并与死亡率、发病率增加及住院时间延长相关。尽管如此,低钠血症患者的管理仍然存在问题。低钠血症在多种情况下普遍存在,且由背景各异的临床医生进行管理,这催生了基于不同机构和专业的诊断与治疗方法。为形成一个共同且全面的观点,以欧洲肾脏最佳实践(ERBP)为代表的欧洲重症监护医学学会(ESICM)、欧洲内分泌学会(ESE)以及欧洲肾脏协会 - 欧洲透析与移植协会(ERA - EDTA),作为代表对低钠血症自然感兴趣的专家的3个学会的合资项目,制定了关于低钠血症诊断方法和治疗的临床实践指南。除了对证据的方法学和评估采取严谨的方法外,该文件侧重于患者的积极结果,并为参与日常实践的临床医生提供一个有用的工具。在本文中,我们展示了从完整指南中提取的关于低钠血症诊断和治疗的建议与意见的简略版本。

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