Dangers of overtreating “mild” hyponatremia?

  • 1 Roger Rodby, MD, FASN, is Professor of Medicine at Rush University Medical Center and a Community Leader for the Patient Care Q&A ASN Community.
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Query and Hypothesis

Is the risk of ODS the same at all levels of starting PNa levels? And if not, perhaps we do not need to re-lower the PNa if starting in the mid-120s?

Discussion

The discussion focused on several points:

The relative change in serum osmolality (and therefore shifting of brain water) is not the same with a 12 meq/L PNa change when you consider, for example, starting at a PNa of 110 vs. 125. Thus, you would not expect the risk of ODS to be the same in those two patients. This is confirmed by the fact that

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