• Antonios H Tzamaloukas, Joseph I Shapiro, Dominic S Raj, Glen H Murata, Robert H Glew, and Deepak Malhotra.
• Renal Section, Medicine Service, Raymond G. Murphy VA Medical Center and Department of Medicine (AHT), University of New Mexico School of Medicine, Albuquerque, New Mexico; Joan C. Edwards School of Medicine (JIS), Marshall University, Huntington, West Virginia; Division of Nephrology and Hypertension, Department of Medicine (DSR), The George Washington University, Washington, District of Columbia; Medicine Service, Raymond G. Murphy VA Medical Center and Department of Medicine (GHM), University of New Mexico School of Medicine, Albuquerque, New Mexico; Department of Surgery (RHG), University of New Mexico School of Medicine, Albuquerque, New Mexico; and Division of Nephrology, Department of Medicine (DM), University of Toledo, Toledo, Ohio.
• Am. J. Med. Sci. 2014 Nov 1; 348 (5): 432-9.

AbstractRapid correction of severe hyponatremia carries the risk of osmotic demyelination. Two recently introduced methods of correction of hyponatremia have diametrically opposite effects on aquaresis. Inhibitors of vasopressin V2 receptor (vaptans) lead to the production of dilute urine, whereas infusion of desmopressin causes urinary concentration. Identification of the category of hyponatremia that will benefit from one or the other treatment is critical. In general, vaptans are effective in hyponatremias presenting with concentrated urine and, with the exception of hypovolemic hyponatremia, can be used as their primary treatment. Desmopressin is effective in hyponatremias presenting with dilute urine or developing urinary dilution after saline infusion. In this setting, desmopressin infusion helps prevent overcorrection of the hyponatremia. Monitoring of the changes in serum sodium concentration as a guide to treatment changes is imperative regardless of the initial treatment of severe hyponatremia.

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