PDF | On Jun 1, , Horacio J. Adrogué and others published Hyponatremia. J Am Soc Nephrol. Jul;23(7) doi: /ASN Epub May The challenge of hyponatremia. Adrogué HJ(1), Madias NE. N Engl J Med. May 25;(21) Hyponatremia. Adrogué HJ(1), Madias NE. Author information: (1)Department of Medicine, Baylor College of.

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adogue Use of this formula stipulates the physician is highly familiar with the medical literature with respect to the management of hyponatremia. Intake and output need to be watched closely.

No part of this application may be duplicated without written permission from the author. Licensee or user shall indemnify, defend and hold harmless licensor, its affiliates, and their respective officers, directors, owners, agents, information providers and employees from and against any claims, demands or causes of action whatsoever, including without limitation those arising on account of, or resulting from the exercise or practice of the license granted hereunder by licensee, its sublicensees, if any, its subsidiaries or other officers, employees, agents or representatives.


The licensee or user understand and agree that the technology and content of this application are provided for educational purposes only. Licensee or user assumes the duty to have any and all laboratory values or calculations verified by a licensed physician.

The challenge of hyponatremia.

Patients with severe acute symptomatic hyponatremia must be managed in the intensive care unit. Formulas may overcorrect the serum sodium so one must use clinical judgment and monitor the serum sodium, intake and output very closely during the critical period.

Whenever using intravenous solutions post operatively, check serum electrolytes at least daily.

All calculations must be checked for accuracy and confirmed before use, clinical or otherwise. The urine output may increase dramatically during correction, leading to over correction Over correction may result in osmotic demyelination, and although this may not be initially apparent, can be a very serious complication.

Nephrologists must monitor electrolytes and fluid output very closely. Neither licensor nor its associated hyponatreemia or other entities warrant the accuracy of any information provided by or resulting from the technology or the content for clinical management, and licensee or user agree that no such persons or entities shall be liable for any adverse consequences resulting from the use of any of the same.


Do not exceed guidelines for correction.

Avoid hypotonic fluids after surgery. All medical decisions must be based upon the clinical judgment of a licensed physician. Electrolytes need to be checked frequently, and fluids adjusted as needed.

Consult a nephrologist early.