Hyponatremia Correction and Osmotic Demyelination Syndrome Risk: A Systematic Review and Meta-Analysis

IF 3.2 Q1 UROLOGY & NEPHROLOGY
Supawadee Suppadungsuk , Pajaree Krisanapan , Sara Kazeminia , Nasrin Nikravangolsefid , Waryaam Singh , Larry J. Prokop , Kianoush B. Kashani , Juan Pablo Domecq Garces
{"title":"Hyponatremia Correction and Osmotic Demyelination Syndrome Risk: A Systematic Review and Meta-Analysis","authors":"Supawadee Suppadungsuk ,&nbsp;Pajaree Krisanapan ,&nbsp;Sara Kazeminia ,&nbsp;Nasrin Nikravangolsefid ,&nbsp;Waryaam Singh ,&nbsp;Larry J. Prokop ,&nbsp;Kianoush B. Kashani ,&nbsp;Juan Pablo Domecq Garces","doi":"10.1016/j.xkme.2024.100953","DOIUrl":null,"url":null,"abstract":"<div><h3>Rationale &amp; Objective</h3><div>Osmotic demyelination syndrome (ODS) is a rare but severe condition often attributed to the rate of sodium collection. We evaluated the association between the overly rapid sodium correction in adult hospitalized patients with ODS.</div></div><div><h3>Study Design</h3><div>Systematic review and meta-analysis.</div></div><div><h3>Setting &amp; Study Populations</h3><div>Adults hospitalized hyponatremia patients.</div></div><div><h3>Selection Criteria for Studies</h3><div>The studies comparing the incidence of ODS with and without rapid sodium correction inception to January 2024.</div></div><div><h3>Data Extraction</h3><div>Two reviewers independently extracted data and assessed the risk of bias and the certainty of evidence.</div></div><div><h3>Analytic Approach</h3><div>The incidence of ODS following a rapid and nonrapid sodium correction was pooled using the random effects model. Subgroup and meta-regression analyses were performed for the robustness and the source of heterogeneity.</div></div><div><h3>Results</h3><div>Eleven cohort studies were included with 26,710 hospitalized hyponatremia patients. The definition of hyponatremia varied from<!--> <!-->&lt;116 to<!--> <!-->&lt;130<!--> <!-->mmol/L, and overly rapid sodium correction was defined as<!--> <!-->&gt;8 to 12<!--> <!-->mmol/L within 24 hours. The overall incidence of ODS was 0.23%. The incidence of ODS in rapid and nonrapid sodium correction was 0.73% and 0.10%, respectively. Meta-analysis demonstrated that a rapid rate of sodium correction was associated with a higher incidence of ODS (odds ratio 3.16, 95% CI, 1.54-6.49, I<sup>2</sup> <!-->=<!--> <!-->27%), whereas some patients with hyponatremia developed ODS without rapid sodium level correction. The sensitivity analysis based on the quality of the studies was consistent with the main result.</div></div><div><h3>Limitation</h3><div>Various definition criteria for ODS diagnosis across studies, lack of potential electrolyte and treatment data that may affect the incidence of ODS.</div></div><div><h3>Conclusions</h3><div>The rapid rate of sodium correction had a statistical correlation with a higher incidence of ODS. Among ODS without rapid correction, further studies are recommended to evaluate and comprehend the relationship for better and proper management of hospitalized patients with hyponatremia.</div></div><div><h3>Plain Language Summary</h3><div>Hyponatremia is a common electrolyte disorder that is essential to treat symptoms to prevent further neurologic complications, even from hyponatremia itself or following treatment. This meta-analysis evaluated the association between sodium correction rate and osmotic demyelination syndrome (ODS). The finding demonstrated that rapid correlation<!--> <!-->&gt;8<!--> <!-->mmol/L/24<!--> <!-->h had a statistical correlation with a higher risk of ODS. Rapid sodium correction occurred in 21.5% of patients with hyponatremia. The overall incidence of ODS was 0.23% and 0.73% among those with rapid sodium correction. Even without rapid correction, 0.1% of patients with hyponatremia developed ODS. Further studies are needed to comprehend the relationship between hyponatremia and ODS among all individuals, including those without rapid correction, to optimize the management of hyponatremia.</div></div>","PeriodicalId":17885,"journal":{"name":"Kidney Medicine","volume":"7 3","pages":"Article 100953"},"PeriodicalIF":3.2000,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Kidney Medicine","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S259005952400164X","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
引用次数: 0

Abstract

Rationale & Objective

Osmotic demyelination syndrome (ODS) is a rare but severe condition often attributed to the rate of sodium collection. We evaluated the association between the overly rapid sodium correction in adult hospitalized patients with ODS.

Study Design

Systematic review and meta-analysis.

Setting & Study Populations

Adults hospitalized hyponatremia patients.

Selection Criteria for Studies

The studies comparing the incidence of ODS with and without rapid sodium correction inception to January 2024.

Data Extraction

Two reviewers independently extracted data and assessed the risk of bias and the certainty of evidence.

Analytic Approach

The incidence of ODS following a rapid and nonrapid sodium correction was pooled using the random effects model. Subgroup and meta-regression analyses were performed for the robustness and the source of heterogeneity.

Results

Eleven cohort studies were included with 26,710 hospitalized hyponatremia patients. The definition of hyponatremia varied from <116 to <130 mmol/L, and overly rapid sodium correction was defined as >8 to 12 mmol/L within 24 hours. The overall incidence of ODS was 0.23%. The incidence of ODS in rapid and nonrapid sodium correction was 0.73% and 0.10%, respectively. Meta-analysis demonstrated that a rapid rate of sodium correction was associated with a higher incidence of ODS (odds ratio 3.16, 95% CI, 1.54-6.49, I2 = 27%), whereas some patients with hyponatremia developed ODS without rapid sodium level correction. The sensitivity analysis based on the quality of the studies was consistent with the main result.

Limitation

Various definition criteria for ODS diagnosis across studies, lack of potential electrolyte and treatment data that may affect the incidence of ODS.

Conclusions

The rapid rate of sodium correction had a statistical correlation with a higher incidence of ODS. Among ODS without rapid correction, further studies are recommended to evaluate and comprehend the relationship for better and proper management of hospitalized patients with hyponatremia.

Plain Language Summary

Hyponatremia is a common electrolyte disorder that is essential to treat symptoms to prevent further neurologic complications, even from hyponatremia itself or following treatment. This meta-analysis evaluated the association between sodium correction rate and osmotic demyelination syndrome (ODS). The finding demonstrated that rapid correlation >8 mmol/L/24 h had a statistical correlation with a higher risk of ODS. Rapid sodium correction occurred in 21.5% of patients with hyponatremia. The overall incidence of ODS was 0.23% and 0.73% among those with rapid sodium correction. Even without rapid correction, 0.1% of patients with hyponatremia developed ODS. Further studies are needed to comprehend the relationship between hyponatremia and ODS among all individuals, including those without rapid correction, to optimize the management of hyponatremia.
求助全文
约1分钟内获得全文 求助全文
来源期刊
Kidney Medicine
Kidney Medicine Medicine-Internal Medicine
CiteScore
4.80
自引率
5.10%
发文量
176
审稿时长
12 weeks
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信