title: [Hyponatremia - a frequent and complex clinical problem].
abstract: Guidelines have become very common in modern medicine. Their primary aim should be to provide evidence-based guidance and insight and to help to convey the best possible care to patients. As a consequence, guidelines also play a critical role in liability issues. Hyponatremia is a frequently encountered condition which is considered challenging by many physicians. It is therefore highly appreciated, that two interdisciplinary guidelines on hyponatremia have been published recently. Unfortunately, the given recommendations differ substantially. Most importantly, the roles of existing new and old treatment options are rated inconsistently. This demonstrates once again that guidelines never tell the whole truth and that we are well advised not to trust them blindly. Given the lack of valid evidence from controlled trials, the current guidelines can only offer another overview on hyponatremia but they certainly fail to provide clear-cut recommendations. The content and controversies of both publications are described in this commentary.
authors.affiliation: Klinik II für Innere Medizin: Nephrologie, Rheumatologie, Diabetologie und Allgemeine Innere Medizin, Universitätsklinik Köln.
authors.forename: Volker
authors.initials: V
authors.lastname: Burst
authors.affiliation: Medizinische Klinik, Klinikum Region Hannover (KRH), Klinikum Nordstadt, Hannover.
authors.forename: Johannes
authors.initials: J
authors.lastname: Hensen
mesh_terms: D004632:Emergency Medical Services / Q000592:standards*; D004704:Endocrinology / Q000592:standards*; D019317:Evidence-Based Medicine; D005858:Germany; D006801:Humans; D007010:Hyponatremia / Q000175:diagnosis* / Q000628:therapy*; D038622:Internationality; D009398:Nephrology / Q000592:standards*; D017410:Practice Guidelines as Topic