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Korean Society of Nephrology 2022 recommendations on controversial issues in diagnosis and management of hyponatremiaopen access

Authors
Lee, YeonheeYoo, Kyung DonBaek, Seon HaKim, Yang GyunKim, Hyo JinRyu, Ji YoungPaek, Jin HyukSuh, Sang HeonOh, Se WonLee, JeonghwanJhee, Jong HyunSuh, Jin-SoonYang, Eun MiPark, Young HoKim, Yae LimChoi, MiyoungOh, Kook-HwanKim, SejoongHyponatremia Guideline Development Group
Issue Date
Nov-2022
Publisher
대한내과학회
Keywords
Hyponatremia; Evidence-based practice; GRADE approach; Guideline; Recommendation
Citation
The Korean Journal of Internal Medicine, v.37, no.6, pp.1120 - 1137
Indexed
SCIE
SCOPUS
KCI
Journal Title
The Korean Journal of Internal Medicine
Volume
37
Number
6
Start Page
1120
End Page
1137
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/61784
DOI
10.3904/kjim.2022.174
ISSN
1226-3303
Abstract
The Korean Society for Electrolyte and Blood Pressure Research, in collaboration with the Korean Society of Nephrology, has published a clinical practice guideline (CPG) document for hyponatremia treatment. The document is based on an extensive evidence-based review of the diagnosis, evaluation, and treatment of hyponatremia with the multidisciplinary participation of representative experts in hyponatremia with methodologist support for guideline development. This CPG consists of 12 recommendations (two for diagnosis, eight for treatment, and two for special situations) based on eight detailed topics and nine key questions. Each recommendation begins with statements graded by the strength of the recommendations and the quality of the evidence. Each statement is followed by rationale supporting the recommendations. The committee issued conditional recommendations in favor of rapid intermittent bolus administration of hypertonic saline in severe hyponatremia, the use of vasopressin receptor antagonists in heart failure with hypervolemic hyponatremia, and syndrome of inappropriate antidiuresis with moderate to severe hyponatremia, the individualization of desmopressin use, and strong recommendation on the administration of isotonic fluids as maintenance fluid therapy in hospitalized pediatric patients. We hope that this CPG will provide useful recommendations in practice, with the aim of providing clinical support for shared decision-making to improve patient outcomes.
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Oh, Se Won
Anam Hospital (Department of Nephrology and Hypertension, Anam Hospital)
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