Abstract: FR-PO0574
Mortality and Neurological Complications Associated with Rapid vs. Slow Correction of Moderate Hyponatremia
Session Information
- Fluid, Electrolyte, and Acid-Base Disorders: Clinical - 2
November 07, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Fluid, Electrolytes, and Acid-Base Disorders
- 1102 Fluid, Electrolyte, and Acid-Base Disorders: Clinical
Authors
- Ayus, Juan Carlos, University of California Irvine, Irvine, California, United States
- Cherne, Pablo Nicolas, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
- Fuentes, Nora, Hospital Privado de Comunidad, Mar del Plata, Buenos Aires Province, Argentina
- Ciapponi, Agustín, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
- Moritz, Michael L., Akron Children's Hospital, Akron, Ohio, United States
- Murujosa, Anaclara, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
Background
A recent meta analysis of severe hyponatremia (SNa ≤ 120 mEq/L) indicates that rapid correction (≥8 mEq/L/24h) is associated with improved in-hospital mortality without an increased risk of ODS (JAMA Intern Med. 2025;185(1):38-51). Information is lacking for moderate hyponatremia (SNa 120 - 130 mEq/L).
Methods
A retrospective cohort study at Hospital Italiano in Buenos Aires, Argentina, included 12,079 adult pts (≥ 18y) hospitalized between 2013 - 24 with an admission SNa (120 and 130 mEq/L) and at least one SNa ≥24 hrs following hospitalization. Patients were categorized according to the rate of SNa correction at 24 hrs as rapid (≥8 mEq/L) or slow (<8 mEq/L), and in-hospital mortality and incidence of ODS were compared. Adjustments for confounding variables were performed using logistic regression models and inverse probability of treatment weighting (IPTW) based on propensity scores. Covariates included age, sex, baseline SNa, comorbidities (CHF, dementia, malignancy, COPD and cirrhosis) and Charlson Index.
Results
The mean age was 74y, and 58% were female. Baseline SNa was lower in the rapid group (126.32 ± 3.31 v 127.27 ± 2.87, p <0.001). Rapid correction occurred in 14% (n = 1,695), with a rate of correction of 9.9 ± 2.3 vs. 3.0 ± 2.7 mEq/L/24hr. Rapid correction was associated with decreased in-hospital mortality (14% vs. 19%, p < 0.001) in both unadjusted (OR 0.65, 95% CI 0.49–0.84, p = 0.002) and adjusted models: Model 1 (age, sex, sodium): OR 0.64 (95% CI 0.54–0.74); Model 2 (Model 1 + Charlson Index): OR 0.63 (95% CI 0.54–0.74); Model 3 (Model 1 + comorbidities): OR 0.63 (95% CI 0.53–0.73); IPTW-weighted model: OR 0.71 (95% CI 0.60–0.84) Figure 1. ODS was present in 6 pts, (0.05%) with a similar incidence between rapid and slow correction (2/1,695 vs. 4/10,384, p = 0.20; Fisher’s exact test).
Conclusion
Rapid correction (≥8 mEq/L/24hr) of moderate hyponatremia is associated with decreased adjusted in-hospital mortality without an increased incidence of ODS.