Department of Internal Medicine, Erasmus University Hospital, ULB, Brussels, Belgium.
Department of Nephrology, Centre EpiCURA, Ath, Belgium.
Expert Rev Endocrinol Metab. 2020 May;15(3):195-214. doi: 10.1080/17446651.2020.1755259. Epub 2020 May 13.
: Hyponatremia is the most common fluid and electrolyte abnormality. It is associated with much higher morbidity and mortality rates than found in non hyponatremic patients.: When the physician is faced to a hyponatremic patient he first has to confirm that hyponatremia is associated with hypoosmolality. Then he must answer to a series of questions: What is its origin? Is it acute or chronic? Which treatment is the most appropriate? We will discuss the various options for the treatment of hypotonic hyponatremia. For a better comprehensive approach of the treatment we will also discuss some pathophysiological data. The use of urea in euvolemic and hypervolemic hyponatremia will be particularly discussed. Literature was reviewed from Jan 1970 to Dec 2019.: Prospective studies showing the benefit in decreasing morbidity by increasing SNa in patients with chronic hyponatremia should be done. These studies should also compare the efficacy and side effects of urea therapy compare to vaptans.
低钠血症是最常见的液体和电解质异常。与非低钠血症患者相比，低钠血症患者的发病率和死亡率要高得多。当医生面对低钠血症患者时，他首先必须确认低钠血症与低渗透压有关。然后他必须回答一系列问题：它的起源是什么？是急性的还是慢性的？哪种治疗方法最合适？我们将讨论治疗低张性低钠血症的各种选择。为了更好地全面治疗，我们还将讨论一些病理生理数据。特别讨论了在等容性和高容性低钠血症中使用尿素。从 1970 年 1 月至 2019 年 12 月，对文献进行了回顾。应该进行前瞻性研究，以证明通过增加慢性低钠血症患者的 SNa 来降低发病率的益处。这些研究还应比较尿素治疗与血管加压素受体拮抗剂治疗的疗效和副作用。
