Abstract: FR-PO0583
Effectiveness of Salt Tablets in Inpatient Hyponatremia Improves with Higher Doses
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
- Minhas, Saleha, UQ-Ochsner Clinical School, New Orleans, Louisiana, United States
- Biggs, Erin, Ochsner Health, New Orleans, Louisiana, United States
- Vargas Marin, Valentina, UQ-Ochsner Clinical School, New Orleans, Louisiana, United States
- Murugadass, Roshini P, UQ-Ochsner Clinical School, New Orleans, Louisiana, United States
- Karras, Elena, UQ-Ochsner Clinical School, New Orleans, Louisiana, United States
- Narayana, Lekha Nare, UQ-Ochsner Clinical School, New Orleans, Louisiana, United States
- Velez, Juan Carlos Q., UQ-Ochsner Clinical School, New Orleans, Louisiana, United States
Group or Team Name
- Ochsner Nephrology.
Background
Salt [sodium chloride (NaCl)] tablets (tab) are often used for the treatment of inpatient hyponatremia (hypoNa) with the goal of providing an osmolar load to promote urinary water excretion. Conceptually, the greater the dose, the greater the osmolar load, the greater the net effect. However, there is limited data assessing whether the effectiveness of NaCl tab is dose-dependent.
Methods
We conducted a 5-year retrospective search of records of hospitalized patients with moderate hyponatremia [serum Na (sNa) < 130 mEq/L] who were treated with 1 g-NaCl tab. For each case, we excluded treatment-days when NaCl tab administration occurred concomitantly or within +/- 24 hrs of additional treatment with either an IV NaCl-containing infusion/bolus (excluding drug vehicle) or oral tolvaptan, Na bicarbonate or Na phosphate. A linear mixed model with random intercepts was performed to assess the effect of daily dose of NaCl tab on the subsequent 24-hr change in sNa, adjusting for baseline sNa, age, sex, serum creatinine (sCr), BUN and urine osmolality (uOsm).
Results
After excluding 47 patients due to concomitant therapy, 30 were included (mean age 72, 67% women, 90% white, mean baseline sNa 125 mEq/L). Etiology of hypoNa was: 25 (83%) SIADH, 2 (7%) SIADH plus low solute intake (LSI), 2 (7%) LSI alone and 1 (3%) LSI plus cirrhosis. Treatment lasted 3.3 days (range 1–6). Common daily NaCl tab doses were 2 g (n=14), 3 g (n=13), 6 g (n=20), 8 g (n=15), and 12 g (n=13). By the end of treatment, sNa rose from 125 to 130 mEq/L (t = –6.04, p<0.001), with 70% increasing ≥ 3 mEq/L. 129 sNa data points were extracted. After adjusting for daily sNa, age, sex, BUN/sCr, and uOsm, each 1 g increase in NaCl tab dose was associated with a 0.45 mEq/L increase in daily sNa (p<0.0001). Excluding 8 patients on loop diuretics (n=23), the association between NaCl tab dose and subsequent sNa remained significant (β = –0.36; p=0.0088). Women experienced a significantly greater increase in sNa, with an average adjusted difference of 2.7 mEq/L (p=0.0316). High doses (i.e., 3 - 4 g tid/qid) were well tolerated, only 1 patient experienced mild nausea.
Conclusion
The effectiveness of NaCl tab for the treatment of inpatient hypoNa is greater when higher doses are used.