This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (64)  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Social Bookmarking   What's this?

Rapid Correction With Urea, Sodium Chloride, and Water Restriction Therapy

Guy Decaux, MD; Jacques Unger, MD; Serge Brimioulle, MD; Jean Mockel, MD, PhD

JAMA. 1982;247(4):471-474.

Abstract
In the syndrome of inappropriate secretion of antidiuretic hormone (SIADH), rapid elevation of serum sodium concentration may be imperative to correct neurological symptoms. Seven patients with hyponatremia secondary to SIADH were treated by oral intake of two to three doses of 30 g of urea over 24 hours or infusion of 80 g of urea as a 30% solution over six hours, water restriction (500 mL/24 hr), and sodium supplements (120 to 360 mmole/24 hr). Serum sodium concentration increased from 117±2 to 126±1.4 mmole/L (mean±SEM) after eight hours, to 130±1.3 mmole/L after 12 hours, and to 134.5±1.2 mmole/L after 24 hours. The normalization of serum sodium was secondary to osmotic diuresis and to sodium retention induced by urea. Use of urea should be considered when symptomatic hyponatremia in SIADH must be quickly corrected.

(JAMA 1982;247:471-474)

Author Affiliations
From the Department of Internal Medicine, St Pierre University Hospital and Institute of Interdisciplinary Research, School of Medicine, Free University of Brussels, Belgium.

Footnotes
Reprint requests to Service de Médecine Interne, Hôpital Universitaire St Pierre, Rue Haute, 322, B-1000 Bruxelles, Belgium (Dr Decaux).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Current and future treatment options in SIADH
Zietse et al.
NDT Plus 2009;2:iii12-iii19.
ABSTRACT | FULL TEXT  

Rapid (24-Hour) Reaccumulation of Brain Organic Osmolytes (Particularly myo-Inositol) in Azotemic Rats after Correction of Chronic Hyponatremia
Soupart et al.
J. Am. Soc. Nephrol. 2002;13:1433-1441.
ABSTRACT | FULL TEXT  

Fatal Central Diabetes Mellitus and Insipidus Resulting from Untreated Hyponatremia: A New Syndrome
Fraser and Arieff
ANN INTERN MED 1990;112:113-119.
ABSTRACT  

Diuretic-Induced Hyponatremia-Reply
Ayus
Arch Intern Med 1986;146:2415-2415.
ABSTRACT  

Chronic Hyponatremia Associated With Diabetic Amyotrophy
Osei and Falko
Arch Intern Med 1986;146:534-536.
ABSTRACT