Hyponatremia: diagnosis, complications, and management including V2 receptor antagonists.
OBJECTIVE
Recent studies have consistently demonstrated the common prevalence of hyponatremia in the hospital and intensive care settings, and how it correlates with untoward outcomes. This review discusses the classification, diagnosis, and pathophysiology of hyponatremia and how these agents may influence its management, and also examines the available treatment options and their weaknesses and strengths.


RESULTS
This review is timely and relevant, as mild degrees of serum sodium lowering may be associated with adverse neurologic and musculoskeletal effects. These findings have the potential to transform our approach to managing hyponatremia. A major advance in our ability to treat hyponatremia was the introduction and approval of aquaretics (vaptans). Emerging data on vaptans and their potential role to treat hyponatremia in the settings of the syndrome of inappropriate antidiuretic hormone secretion, congestive heart failure, and liver cirrhosis are presented.


CONCLUSIONS
Vaptans will likely play an important role in treating hyponatremia, given their clinical effectiveness and tolerability. Cost remains a hindrance for vaptans, and more studies are needed to further define their best utilization in hyponatremic patients.
Division of Renal Diseases and Hypertension, University of Colorado-Denver, 12700 East 19th Avenue, Aurora, CO 80045, USA.
Elwaleed A
EA
Elhassan
Robert W
RW
Schrier
D000222:Adaptation, Physiological; D065092:Antidiuretic Hormone Receptor Antagonists; D001552:Benzazepines / Q000627:therapeutic use; D001921:Brain / Q000502:physiology; D015444:Exercise; D006333:Heart Failure / Q000188:drug therapy; D006801:Humans; D007010:Hyponatremia / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D007177:Inappropriate ADH Syndrome / Q000188:drug therapy; D008103:Liver Cirrhosis / Q000188:drug therapy; D000077602:Tolvaptan
D065092:Antidiuretic Hormone Receptor Antagonists; D001552:Benzazepines; D000077602:Tolvaptan