DDAVP Is Effective in Preventing and Reversing Inadvertent... : Clinical Journal of the American Society of Nephrology (original) (raw)
Acid Base/Mineral Metabolism
DDAVP Is Effective in Preventing and Reversing Inadvertent Overcorrection of Hyponatremia
Perianayagam, Anjana; Sterns, Richard H.; Silver, Stephen M.; Grieff, Marvin; Mayo, Robert; Hix, John; Kouides, Ruth
*Rochester General Hospital, Department of Medicine, and †University of Rochester School of Medicine and Dentistry, Rochester, New York
Correspondence: Dr. Richard H. Sterns, 1425 Portland Avenue, Rochester NY 14621. Phone: 585-922-4242; Fax: 585-922-4440; E-mail: [email protected]
Accepted December 27, 2007
Received August 6, 2007
Clinical Journal of the American Society of Nephrology 3(2):p 331-336, March 2008. | DOI: 10.2215/CJN.03190807
Abstract
Background and objectives: Adherence to therapeutic guidelines for the treatment of hyponatremia becomes difficult when water diuresis emerges during therapy. The objective of this study was to assess the effectiveness and safety of desmopressin acetate as a therapeutic agent to avoid overcorrection of hyponatremia and to lower the plasma sodium concentration again after inadvertent overcorrection.
Design, setting, participants, & measurements: Retrospective chart review was conducted of all patients who were given desmopressin acetate during the treatment of hyponatremia during 6 yr in a 528-bed community teaching hospital.
Results: Six patients (group 1) were given desmopressin acetate after the 24-h limit of 12 mmol/L had already been reached or exceeded; correction was prevented from exceeding the 48-h limit of 18 mmol/L in five of the six. Fourteen patients (group 2) were given desmopressin acetate in anticipation of overcorrection after the plasma sodium concentration had increased by 1 to 12 mmol/L. In all 14 patients who were treated with desmopressin acetate as a preventive measure, correction was prevented from exceeding either the 24- or 48-h limits. After desmopressin acetate was administered, the plasma sodium concentration of 14 of the 20 patients fell by 2 to 9 mmol/L. In all six group 1 patients and in five of the group 2 patients, the plasma sodium concentration was actively lowered again by the concurrent administration of desmopressin acetate and 5% dextrose in water; no serious adverse consequences from this maneuver were observed.
Conclusion: Desmopressin acetate is effective in preventing and reversing inadvertent overcorrection of hyponatremia.
Copyright © 2008 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.
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