Journal Article

Current prescriptions for the correction of hyponatraemia and hypernatraemia: are they too simple?

Noha R. Barsoum and Barton S. Levine

in Nephrology Dialysis Transplantation

Published on behalf of European Renal Association - European Dialysis and Transplant Assoc

Volume 17, issue 7, pages 1176-1180
Published in print July 2002 | ISSN: 0931-0509
Published online July 2002 | e-ISSN: 1460-2385 | DOI: http://dx.doi.org/10.1093/ndt/17.7.1176
Current prescriptions for the correction of hyponatraemia and hypernatraemia: are they too simple?

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Hypo‐ and hypernatraemic (dysnatraemic) disorders are among the most common electrolyte disorders encountered by primary care providers and nephrologists. They represent a diagnostic and therapeutic challenge, and inappropriate management can result in serious sequelae. Several formulas addressing the fluid prescription for dysnatraemic patients have been introduced. Many authors stress the importance of considering output as well as input in formulating a treatment plan for the dysnatraemic patient. However, currently available formulas fail to account for ongoing renal and extrarenal fluid and electrolyte losses. We propose a novel, versatile formula based on established principles governing the distribution of Na+ in body fluids. The formula can be used in a simplified form for a quick but accurate estimate of the change in serum [Na+] for any infused fluid, while simultaneously accounting for renal losses. The formula can also be expanded to include more complex losses if desired. Importantly, it forces the caregiver to consider both output and input when formulating a prescription for the dysnatraemic patient.

Keywords: fluid prescription; formula; hypernatraemia; hyponatraemia

Journal Article.  2697 words.  Illustrated.

Subjects: Nephrology

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