Skip to main content
Top
Published in: BMC Medicine 1/2015

Open Access 01-12-2015 | Commentary

Diagnosis and management of hyponatraemia: AGREEing the guidelines

Author: Alexander P Maxwell

Published in: BMC Medicine | Issue 1/2015

Login to get access

Abstract

Hyponatraemia is a common electrolyte disorder associated with significant complications and controversies regarding its optimal management. Clinical practice guidelines and consensus statements have attempted to provide clinicians with evidence-based diagnostic and treatment strategies for hyponatraemia. Recently published guidance documents differ in their methods employed to review the quality of available evidence. Nagler et al. used the Appraisal of Guideline for Research and Evaluation (AGREE II) instrument in a systematic review of guidelines and consensus statements for the diagnosis and management of hyponatraemia. Nagler and colleagues highlighted the variability in methodological rigour applied to guideline development and inconsistencies between publications in relation to management of hyponatraemia (including the recommended rate of correction of a low serum sodium concentration). These differences could cause confusion for practising physicians managing patients with hyponatraemia.
Literature
1.
2.
go back to reference Nagler EV, Jill V, van der Veer SN, Ionut N, Van Wim B, Webster AC, et al. Diagnosis and treatment of hyponatremia: a systematic review of clinical practice guidelines and consensus statements. BMC Med. 2014;12:231.CrossRef Nagler EV, Jill V, van der Veer SN, Ionut N, Van Wim B, Webster AC, et al. Diagnosis and treatment of hyponatremia: a systematic review of clinical practice guidelines and consensus statements. BMC Med. 2014;12:231.CrossRef
3.
go back to reference Sterns RH. Disorders of plasma sodium – causes, consequences, and correction. N Engl J Med. 2015;372:55–65.CrossRefPubMed Sterns RH. Disorders of plasma sodium – causes, consequences, and correction. N Engl J Med. 2015;372:55–65.CrossRefPubMed
4.
go back to reference Kinsella S, Moran S, Sullivan MO, Molloy MG, Eustace JA. Hyponatremia independent of osteoporosis is associated with fracture occurrence. Clin J Am Soc Nephrol. 2010;5:275–80.CrossRefPubMedPubMedCentral Kinsella S, Moran S, Sullivan MO, Molloy MG, Eustace JA. Hyponatremia independent of osteoporosis is associated with fracture occurrence. Clin J Am Soc Nephrol. 2010;5:275–80.CrossRefPubMedPubMedCentral
5.
go back to reference Hoorn EJ, Zietse R. Hyponatremia and mortality: moving beyond associations. Am J Kidney Dis. 2013;62:139–49.CrossRefPubMed Hoorn EJ, Zietse R. Hyponatremia and mortality: moving beyond associations. Am J Kidney Dis. 2013;62:139–49.CrossRefPubMed
6.
go back to reference Sterns RH, Riggs JE, Schochet Jr SS. Osmotic demyelination syndrome following correction of hyponatremia. N Engl J Med. 1986;314:1535–42.CrossRefPubMed Sterns RH, Riggs JE, Schochet Jr SS. Osmotic demyelination syndrome following correction of hyponatremia. N Engl J Med. 1986;314:1535–42.CrossRefPubMed
7.
go back to reference Brouwers MC, Kho ME, Browman GP, Burgers JS, Cluzeau F, Feder G, et al. AGREE Next Steps Consortium. AGREE II: advancing guideline development, reporting and evaluation in health care. CMAJ. 2010;182:E839–42.CrossRefPubMedPubMedCentral Brouwers MC, Kho ME, Browman GP, Burgers JS, Cluzeau F, Feder G, et al. AGREE Next Steps Consortium. AGREE II: advancing guideline development, reporting and evaluation in health care. CMAJ. 2010;182:E839–42.CrossRefPubMedPubMedCentral
8.
go back to reference Spasovski G, Vanholder R, Allolio B, Annane D, Ball S, Bichet D, et al. Hyponatraemia Guideline Development Group. Clinical practice guideline on diagnosis and treatment of hyponatraemia. Nephrol Dial Transplant. 2014;2:i1–i39.CrossRef Spasovski G, Vanholder R, Allolio B, Annane D, Ball S, Bichet D, et al. Hyponatraemia Guideline Development Group. Clinical practice guideline on diagnosis and treatment of hyponatraemia. Nephrol Dial Transplant. 2014;2:i1–i39.CrossRef
9.
go back to reference Verbalis JG, Goldsmith SR, Greenberg A, Korzelius C, Schrier RW, Sterns RH, et al. Diagnosis, evaluation, and treatment of hyponatremia: expert panel recommendations. Am J Med. 2013;126:S1–42.CrossRefPubMed Verbalis JG, Goldsmith SR, Greenberg A, Korzelius C, Schrier RW, Sterns RH, et al. Diagnosis, evaluation, and treatment of hyponatremia: expert panel recommendations. Am J Med. 2013;126:S1–42.CrossRefPubMed
10.
go back to reference Berl T, Quittnat-Pelletier F, Verbalis JG, Schrier RW, Bichet DG, Ouyang J, et al. Oral tolvaptan is safe and effective in chronic hyponatremia. J Am Soc Nephrol. 2010;21:705–12.CrossRefPubMedPubMedCentral Berl T, Quittnat-Pelletier F, Verbalis JG, Schrier RW, Bichet DG, Ouyang J, et al. Oral tolvaptan is safe and effective in chronic hyponatremia. J Am Soc Nephrol. 2010;21:705–12.CrossRefPubMedPubMedCentral
Metadata
Title
Diagnosis and management of hyponatraemia: AGREEing the guidelines
Author
Alexander P Maxwell
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Medicine / Issue 1/2015
Electronic ISSN: 1741-7015
DOI
https://doi.org/10.1186/s12916-015-0277-8

Other articles of this Issue 1/2015

BMC Medicine 1/2015 Go to the issue