Hyponatremia is a serious, but often overlooked,
electrolyte imbalance that has been independently associated with a wide range of deleterious changes involving many different body systems. Untreated acute
hyponatremia can cause substantial morbidity and mortality as a result of osmotically induced
cerebral edema, and excessively rapid correction of chronic
hyponatremia can cause severe neurologic impairment and death as a result of osmotic
demyelination. The diverse etiologies and comorbidities associated with
hyponatremia pose substantial challenges in managing this disorder. In 2007, a panel of experts in
hyponatremia convened to develop the
Hyponatremia Treatment Guidelines 2007: Expert Panel Recommendations that defined strategies for clinicians caring for patients with
hyponatremia. In the 6 years since the publication of that document, the field has seen several notable developments, including new evidence on morbidities and complications associated with
hyponatremia, the importance of treating mild to moderate
hyponatremia, and the efficacy and safety of
vasopressin receptor antagonist therapy for hyponatremic patients. Therefore, additional guidance was deemed necessary and a panel of
hyponatremia experts (which included all of the original panel members) was convened to update the previous recommendations for optimal current management of this disorder. The updated expert panel recommendations in this document represent recommended approaches for multiple etiologies of
hyponatremia that are based on both consensus opinions of experts in
hyponatremia and the most recent published data in this field.