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Related Experiment Videos

Hypernatremia and lactulose therapy.

D C Nelson, W R McGrew, A M Hoyumpa

    JAMA
    |March 11, 1983
    PubMed
    Summary
    This summary is machine-generated.

    Lactulose, used for hepatic encephalopathy, can cause dangerous hypernatremia (high sodium). This condition, linked to increased mortality, may result from lactulose

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    Area of Science:

    • Hepatology
    • Nephrology
    • Clinical Pharmacology

    Background:

    • Lactulose is a common treatment for portal-systemic encephalopathy (PSE).
    • While generally safe, lactulose has been associated with rare cases of hypernatremia.
    • The relationship between lactulose therapy and hypernatremia in patients with hepatic failure requires further investigation.

    Purpose of the Study:

    • To evaluate the association between lactulose treatment and the development of hypernatremia in patients with hepatic failure.
    • To assess the impact of lactulose-induced hypernatremia on mortality rates.

    Main Methods:

    • Retrospective analysis of patient records.
    • Inclusion criteria: patients with hepatic failure treated with lactulose for encephalopathy.

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  • Monitoring of serum sodium levels and mortality outcomes.

    • Main Results:

    • Hypernatremia (serum sodium > 145 mEq/L) occurred in 20 out of 75 lactulose treatment courses.
    • Mortality was significantly higher in patients who developed hypernatremia (41%) compared to those who remained normonatremic (14%).
    • Hypernatremia persisted in non-survivors and resolved in survivors.

    Conclusions:

    • Lactulose therapy is associated with a significant risk of hypernatremia in patients with hepatic failure.
    • Hypernatremia in this context is linked to increased mortality.
    • The proposed mechanism involves lactulose's osmotic cathartic effect leading to excessive fecal water loss.