Pneumologie 2013; 67 - P353
DOI: 10.1055/s-0033-1334576

Hyponatremia in the Hospital Setting: Interim Results from a Prospective, Observational, Multi-Center, Global Registry

V Burst 1, J Verbalis 2, A Greenberg 3, C Werner 4, D Rudolf 4, J Chiodo III 5
  • 1Universitätsklinik Köln
  • 2Georgetown University, Washington, DC, USA
  • 3Duke University Medical Center, Division of Nephrology, Durham, USA
  • 4Otsuka Pharma GmbH, Frankfurt a.M.
  • 5Otsuka America Pharmaceutical, Inc, Princeton, USA

Introduction and aims:

Hyponatremia (HN) is the leading electrolyte abnormality in hospitalized patients (pts), and an independent predictor of increased mortality. This registry is designed to observe currently utilized management modalities for HN, characterize their relative efficacy, and assess their impact on hospital resource utilization.


After informed consent or waiver, medical records of pts meeting the registry entry criteria, principally age ≥18 years, and euvolemic or hypervolemic HN (serum sodium ([Na]) ≤130 mmol/L) were abstracted. Accrual to date represents approximately 60% of the projected enrollment; data are summarized by sample size (n) and percentage (%) for categorical data, and mean and standard deviation for continuous data.


A total of 1188 of the 2681 pts enrolled between study initiation in September 2010 and September 2012 at 149 US and 92 European sites had sufficient data for analysis. Of these, 288 (29%) were diagnosed with SIADH due to pulmonary causes, including 79 pts admitted to the hosptial for HN and 87 pts with an admission with HN within the last 12 months. Etiologies included lung cancer 47%, pneumonia 15%, COPD 26%, and other pulmonary disorder 12%. The mean entry and discharge [Na] values were 122.6 ± 9.4 mmol/L, and 131.7 ± 5.3 mmol/L, respectively. The average length of stay in days was 9.49 ± 7.47. Treatments received included any pharmacologic agent (diuretic, vaptan, demeclocycline) 102 pts, tolvaptan 53 pts, fluid restriction 137 pts, hypertonic saline 38 pts, normal saline 140 pts,and no treatment 52 pts. 41% were discharged still with HN, and the mean discharge[Na] in pts receiving any treatment and those receiving no treatment at all were 131.8 ± 5.18 and 131.5 ± 6.29 respectively.


Pulmonary disorders accounted for a significant portion of SIADH pts. Up to 52/288 (18%) received no treatment at all for HN and a large number of patients were discharged with persistent HN. Physicians appear to place a low priority on correcting HN before discharge.