DDAVP is effective in preventing and reversing inadvertent overcorrection of hyponatremia.
OBJECTIVE
Adherence to therapeutic guidelines for the treatment of hyponatremia becomes difficult when water diuresis emerges during therapy. The objective of this study was to assess the effectiveness and safety of desmopressin acetate as a therapeutic agent to avoid overcorrection of hyponatremia and to lower the plasma sodium concentration again after inadvertent overcorrection.


METHODS
Retrospective chart review was conducted of all patients who were given desmopressin acetate during the treatment of hyponatremia during 6 yr in a 528-bed community teaching hospital.


RESULTS
Six patients (group 1) were given desmopressin acetate after the 24-h limit of 12 mmol/L had already been reached or exceeded; correction was prevented from exceeding the 48-h limit of 18 mmol/L in five of the six. Fourteen patients (group 2) were given desmopressin acetate in anticipation of overcorrection after the plasma sodium concentration had increased by 1 to 12 mmol/L. In all 14 patients who were treated with desmopressin acetate as a preventive measure, correction was prevented from exceeding either the 24- or 48-h limits. After desmopressin acetate was administered, the plasma sodium concentration of 14 of the 20 patients fell by 2 to 9 mmol/L. In all six group 1 patients and in five of the group 2 patients, the plasma sodium concentration was actively lowered again by the concurrent administration of desmopressin acetate and 5% dextrose in water; no serious adverse consequences from this maneuver were observed.


CONCLUSIONS
Desmopressin acetate is effective in preventing and reversing inadvertent overcorrection of hyponatremia.
Perianayagam
Anjana
A
Rochester General Hospital, Department of Medicine, 1425 Portland Avenue, Rochester NY 14621, USA.
Sterns
Richard H
RH
Silver
Stephen M
SM
Grieff
Marvin
M
Mayo
Robert
R
Hix
John
J
Kouides
Ruth
R
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D050034:Antidiuretic Agents / Q000627:therapeutic use*; D003894:Deamino Arginine Vasopressin / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006955:Hypernatremia / Q000139:chemically induced* / Q000517:prevention & control*; D007010:Hyponatremia / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
D050034:Antidiuretic Agents; D003894:Deamino Arginine Vasopressin