저나트륨혈증의 치료 = Treatment of Hyponatremia

다국어 초록 (Multilingual Abstract)

Hyponatremia, well known as a serious medical condition, is the most frequent electolyte disorder in clinical medicine. Many excellent reviews regarding etiology, pathophysiology, and managements of it have been published, so far. However, considerable controversy still exits regarding the treatment of hyponatremia. The purpose of this review is to bring to the readers a reappraisal of the outcomes of slow or rapid correction of hyponatremia and to suggest our guidelines on the treatment of hyponatremia based on it. Review of the literatures leads to us that patients with symptomatic hyponatremia that develops in the hospital or severe hyponatremia whose genesis has been observed to be rapid can tolerate a rapid rise in serum sodium. Such review also suggests that patients with symptomatic hyponatremia in whom the diagnosis is established upon admission to the hospital have either adapted to hyponatremia and therefore can be treated slowly, or have advanced cerebral damage and are beyond help. In dealing with patients who are admitted to teh hospital with symptomatic hyponatremia, it is best to correct hyponatremia at no more than 0.5mEq/l/h with limiting the maximum rate of increase in serum sodium to 8 mEq/l/day, but 5-6 mEq of this increase can be accomplished in 2-3 h for patients with convulsions that do not respond to the conventional anticonvulsant therapy.