title: 'Dos and don'ts' in the management of hyponatremia.
abstract: OBJECTIVE
  The management of hyponatremia has evolved in recent years, particularly with the introduction of tolvaptan for hyponatremia secondary to the syndrome of inappropriate antidiuretic hormone secretion (SIADH). This commentary presents a summary of recent international recommendations in the form of a series of didactic 'dos and don'ts', in order to provide concise, practical guidance for practising clinicians focused on the investigation and management of euvolemic hyponatremia (SIADH).
  
  
  METHODS
  A multidisciplinary group of international experts reviewed existing guidelines and the evidence cited within to summarize the recommendations in a practical method for use in clinical practice.
  
  
  CONCLUSIONS
  The 'dos and don'ts' are presented under topic headings that include diagnosis and diagnostic tests, specific causes, correction of acute hyponatremia, correction rates for chronic hyponatremia, management of SIADH including fluid restriction, hypertonic saline and pharmacological strategies, and management of overcorrection. Within each topic, the authors summarize the published recommendations on managing hyponatremia and the use of specific agents for the treatment of SIADH.
  
  
  CONCLUSIONS
  Practising clinicians can use these 'dos and don'ts' to provide clear, up-to-date guidance on how to manage hyponatremia and the use of tolvaptan in SIADH.
authors.affiliation: a a Department of Endocrinology , King's College Hospital London , UK.
authors.forename: Simon
authors.initials: S
authors.lastname: Aylwin
authors.affiliation: b b Department II of Internal Medicine: Nephrology , Rheumatology, Diabetes and General Internal Medicine, University of Cologne , Cologne , Germany.
authors.forename: Volker
authors.initials: V
authors.lastname: Burst
authors.affiliation: c c Endocrine Unit, Department of Experimental and Clinical Biomedical Sciences 'Mario Serio', University of Florence , Florence , Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Peri
authors.affiliation: d d Department of Endocrinology and Nutrition , Hospital Clínico San Carlos , Madrid , Spain.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Runkle
authors.affiliation: e e Department of Medical Oncology , Christie Hospital NHS Trust , Manchester , UK.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Thatcher
mesh_terms: D065092:Antidiuretic Hormone Receptor Antagonists / Q000627:therapeutic use; D001552:Benzazepines / Q000627:therapeutic use*; D019468:Disease Management; D005440:Fluid Therapy / Q000379:methods; D006801:Humans; D007010:Hyponatremia / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D007177:Inappropriate ADH Syndrome / Q000150:complications / Q000628:therapy; D017410:Practice Guidelines as Topic; D012462:Saline Solution, Hypertonic / Q000627:therapeutic use*; D000077602:Tolvaptan; D014882:Water-Electrolyte Balance / Q000187:drug effects
chemical_list: D065092:Antidiuretic Hormone Receptor Antagonists; D001552:Benzazepines; D012462:Saline Solution, Hypertonic; D000077602:Tolvaptan
keywords: Hyponatremia; Hypothyroidism; SIADH; Sodium; Sterns’ Safety Rule of Sixes; Syndrome of inappropriate antidiuretic hormone secretion; Tolvaptan; Urea