title: Awareness and management of hyponatraemia: the Italian Hyponatraemia Survey.
abstract: BACKGROUND
  Hyponatraemia is the most frequent electrolyte disorder in hospitalized patients and has been associated with increased morbidity, mortality and length of hospital stay. There is evidence that also mild chronic hyponatraemia may have clinical consequences, such as gait disturbances, attention deficits, falls, increased risk of fractures and reduced bone mineral density. Nevertheless, this condition appears to be rather often not taken into consideration, or inappropriately managed and treated, thus negatively affecting patients' outcome.
  
  
  OBJECTIVE
  The aim of this study was to investigate the awareness and management of hyponatraemia secondary to SIAD, a common cause of hyponatraemia, among Italian physicians (endocrinologists, nephrologists, internists) commonly involved as consultants.
  
  
  METHODS
  A questionnaire, covering definition, diagnosis, management, treatment and prognosis of hyponatraemia secondary to SIAD, was developed with the support of the Italian Society of Endocrinology.
  
  
  RESULTS
  Among the respondents (n=275), the majority was aware of the negative implications of hyponatraemia or of an inappropriate treatment. Nevertheless, the answers indicated that SIAD is still underdiagnosed and incorrectly managed in clinical practice. In particular, only 47% of respondents used the validated biochemical parameters to diagnose hyponatraemia secondary to SIAD. The survey also indicated a rather satisfactory knowledge of the therapeutic options, including the currently available vasopressin receptor antagonists.
  
  
  CONCLUSIONS
  One of the main findings of the survey was that the diagnostic work-up of hyponatraemia still represents a critical issue. Therefore, there is urgent need of educational programs in order to improve the management of this condition and reduce morbidity, mortality and costs.
authors.affiliation: Department of Experimental and Clinical Biomedical Sciences, Endocrine Unit, Center for Research, Transfer and High Education DENOThe, University of Florence, Florence, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Giuliani
authors.forename: M
authors.initials: M
authors.lastname: Cangioli
authors.forename: P
authors.initials: P
authors.lastname: Beck-Peccoz
authors.forename: M
authors.initials: M
authors.lastname: Faustini-Fustini
authors.forename: E
authors.initials: E
authors.lastname: Fiaccadori
authors.forename: A
authors.initials: A
authors.lastname: Peri
mesh_terms: D002983:Clinical Competence; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007010:Hyponatremia / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D007177:Inappropriate ADH Syndrome / Q000150:complications* / Q000175:diagnosis; D007558:Italy / Q000453:epidemiology; D011795:Surveys and Questionnaires
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