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KMID : 1128320220200010021
Electrolytes & Blood Pressure
2022 Volume.20 No. 1 p.21 ~ p.38
Korean Society of Nephrology 2022 Recommendations on Controversial Issues in Diagnosis and Management of Hyponatremia
Lee Yeon-Hee

Yoo Kyung-Don
Baek Seon-Ha
Kim Yang-Gyun
Kim Hyo-Jin
Ryu Ji-Young
Paek Jin-Hyuk
Suh Sang-Heon
Oh Se-Won
Lee Jeong-Hwan
Jhee Jong-Hyun
Suh Jin-Soon
Yang Eun-Mi
Park Young-Ho
Kim Yae-Lim
Choi Mi-Young
Oh Kook-Hwan
Kim Se-Joong
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 methodo- logist 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 condi- tional 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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