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Abstract: SA-PO0508

Neuropathological Correlates of Correction of Chronic Hyponatremia with Small Increment in Rats

Session Information

Category: Fluid, Electrolytes, and Acid-Base Disorders

  • 1101 Fluid, Electrolyte, and Acid-Base Disorders: Basic

Authors

  • Gankam Kengne, Fabrice, Centre Hospitalier EpiCURA asbl, Ath, Walloon Region, Belgium
  • Soupart, Alain, Iris Ziekenhuizen Zuid Joseph Bracops, Brussels, Belgium
  • Decaux, Guy, Universite Libre de Bruxelles Faculte de Medecine, Brussels, Belgium
Background

Rapid correction of profound chronic hyponatremia (hypoNa) can cause osmotic demyelination syndrome. In an experimental model, the minimal sodium increment (ΔNa) required to induce ODS is between 18-25 mEq/l/day but demyelinative lesions are only the final part of a larger neuropathological spectrum which includes astrogliosis, astrocyte loss, and microglial activation. The existence and the extend neuropathological lesions other than myelin loss after rapid correction of serum sodium (SNa) with a ΔNa below 18-25 mEq/l/day is unknown.
We investigated astrocyte loss, astrogliosis and microglial activation in rats after rapid correction of ypoNa with a "small " ΔNa in a large series of rats.

Methods

HypoNa was induced for 3 days in rats and rapidly corrected. ΔNa was used to classify animals in 4 groups(Gr) . Gr 1 to 4: animals with a ΔNa of 5-10, 10-15, 15-20 and 20-23 mEq/l respectively. Based on signs of neurological impairment, they were divided in symptomatic and asymptomatic. In Gr 1 and 2, the ΔNa was recorded over a period of 48 hrs.
Neurological impairment and weight loss were recorded up to 6 days after the correction of SNa and astrocyte loss, gliosis, and microglial activation were investigated by IHC.

Results

In Gr 1 and 2 - ΔNa of less than 15 mEq/L at any given 24 hrs over 48 hrs – all animals were asymptomatic, regained weight by the end of the experiment but displayed some neuropathological changes with gliosis, Astrocyte loss and microglial activation present in 40% (13/20), 25% (5/20) and 20% (4/20) of animals. In all the asymptomatic animals, these lesions were present in 56%(20/36) , 39% (14/36), and 31% (11/36) respectively.

Conclusion

In rats, neuropathological lesions can occur after rapid correction of chronic hypoNa with small increments despite the absence of clinical signs. Their significance and translation to human practice is unclear.

Funding

  • Clinical Revenue Support

Digital Object Identifier (DOI)