[Effectiveness of the administration of a dietary supplement (oral urea) for the treatment of hyponatremia in SIADH].

IF 2.5 4区医学 Q3 BUSINESS

Nutricion hospitalaria Pub Date : 2024-11-05 DOI:10.20960/nh.05516

Ángel Martínez González, Manuella González Nunes, José Llópiz Castedo, Pedro Rodeiro Escobar, Joana Isabel Silva Sousa, Julia Rodríguez Pulian, Camila Sieiro Peña, Thalia Chantal Rodríguez Castiñeira

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引用次数: 0

Abstract

Background and objectives: the most common cause of hyponatraemia in hospital settings is the syndrome of inappropriate antidiuretic hormone secretion (SIADH). This study compares the efficacy and safety of urea versus fluid restriction in the treatment of hyponatraemia caused by SIADH.

Material and methods: an observational cohort study was conducted with 212 patients suffering from hyponatremia (Na+ < 135 mmol/L) due to SIADH at the Complejo Hospitalario Universitario de Pontevedra between January 2015 and May 2022. Of these, 112 patients received urea (15 g/day) and 100 were treated with fluid restriction (1 liter/day). The primary objective was to normalize sodium levels (Na ≥ 135 mmol/L).

Results: urea was significantly more effective than fluid restriction. Sodium levels increased from 126.35 to 133.9 mmol/L with urea, compared to an increase from 126.44 to 130.5 mmol/L with fluid restriction (p < 0.001). Sodium normalization was achieved in an average of 6 days with urea, compared to 8 days with fluid restriction (p = 0.04). At discharge, 59.8 % of patients treated with urea reached normal sodium levels, compared to 42 % in the fluid restriction group (p = 0.007). The 60-day mortality rate was lower in the urea group (16.1 %) compared to the fluid restriction group (32.8 %) (p < 0.007).

Conclusion: urea is more effective than fluid restriction in normalizing sodium levels, with a better safety profile and lower 60-day mortality.

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[服用膳食补充剂（口服尿素）治疗 SIADH 低钠血症的效果]。

背景和目的：在医院环境中，导致低钠血症的最常见原因是抗利尿激素分泌不当综合征（SIADH）。本研究比较了尿素与液体限制治疗 SIADH 引起的低钠血症的有效性和安全性。材料与方法：2015 年 1 月至 2022 年 5 月期间，庞特韦德拉大学综合医院对 212 名 SIADH 引起的低钠血症（Na+ < 135 mmol/L）患者进行了观察性队列研究。其中，112 名患者接受了尿素治疗（15 克/天），100 名患者接受了液体限制治疗（1 升/天）。主要目标是使钠水平恢复正常（Na ≥ 135 mmol/L）。结果：尿素的效果明显优于液体限制。尿素可使钠水平从 126.35 mmol/L 上升至 133.9 mmol/L，而限制输液可使钠水平从 126.44 mmol/L 上升至 130.5 mmol/L（P < 0.001）。尿素疗法平均 6 天就能使钠含量恢复正常，而限制输液疗法则需要 8 天（p = 0.04）。出院时，59.8% 接受尿素治疗的患者钠含量达到正常水平，而限制输液组为 42%（p = 0.007）。尿素组的 60 天死亡率（16.1%）低于限制输液组（32.8%）（p < 0.007）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Nutricion hospitalaria 医学-营养学

CiteScore

1.90

自引率

8.30%

发文量

181

审稿时长

3-6 weeks

期刊介绍： The journal Nutrición Hospitalaria was born following the SENPE Bulletin (1981-1983) and the SENPE journal (1984-1985). It is the official organ of expression of the Spanish Society of Clinical Nutrition and Metabolism. Throughout its 36 years of existence has been adapting to the rhythms and demands set by the scientific community and the trends of the editorial processes, being its most recent milestone the achievement of Impact Factor (JCR) in 2009. Its content covers the fields of the sciences of nutrition, with special emphasis on nutritional support.