Hyponatraemia—Current Treatment Strategies and Perspectives for the Future
Hyponatremia is the commonest electrolyte abnormality found in hospital inpatients and is associated with a greatly increased morbidity and mortality. The management of hyponatremia is predicated on correct diagnosis of the underlying cause, which relies on accurate assessment of the patient’s volume status. The syndrome of inappropriate antidiuresis (SIAD) is the most common cause of hyponatremia and current treatments for this syndrome are poorly effective. Hypervolemic hyponatremia is also difficult to manage. The emergence of a new class of medications—the selective vasopressin-2 receptor antagonists or vaptans—gives clinicians an opportunity to target the underlying pathophysiology of these conditions, and represent an exciting new development in the management of hyponatremia. In this article we review the differential diagnosis of hyponatremia, current treatment strategies, and emerging management options.