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DDAVP to prevent rapid correction in hyponatremia
1Queen's University Nephrology, Kingston General Hospital, Ontario, Canada.
Clinical Nephrology
|April 5, 2000
Summary
Rapid correction of hyponatremia can be managed with desmopressin (dD-AVP). This treatment safely slows serum sodium rise by reducing free water excretion, simplifying patient fluid therapy.
Area of Science:
- Nephrology
- Endocrinology
- Internal Medicine
Background:
- Severe hyponatremia management can be complicated by excessive free water diuresis.
- Rapid serum sodium correction ( > 10-15 mmol/l/24 hours) poses neurological risks.
Observation:
- A 56-year-old female with hyponatremia due to polydipsia experienced brisk free water diuresis.
- Despite fluid administration, serum sodium rose 19 mmol/l in 19 hours with dilute urine (61 mmol/kg).
Findings:
- Intravenous desmopressin (dD-AVP) 8 microg was administered to reduce free water excretion.
- dD-AVP increased urine osmolality, decreased urine volume, and temporarily lowered serum sodium by 2 mmol/l.
- Subsequently, serum sodium rose by 4 mmol/l in 24 hours without neurological sequelae.
Implications:
- Desmopressin (dD-AVP) can safely mitigate rapid free water diuresis during hyponatremia correction.
- This intervention helps slow the rate of serum sodium increase, simplifying fluid management.
- dD-AVP offers a therapeutic option for preventing overly rapid correction of hyponatremia.