Article Figures & Data
Figures
- Figure 1.
Increase in plasma sodium (Na) from baseline to the completion of therapy among urea only–treated patients.
Tables
- Table 1.
Baseline characteristics of patients admitted to the University of Pittsburgh Medical Center with hyponatremia and treated with urea between July 2016 and August 2017
Characteristic N=58 Demographic characteristics Median age [IQR], yr 68 [55–79] Men, N (%) 35 (60.3) Clinical and treatment characteristics Etiology of hyponatremia, N (%) SIADHb 47 (81) Medications 18 (31) Idiopathic 13 (22) Intracranial disorders 13 (22) Malignancy 10 (17) Pulmonary disorders 8 (14) Pain 7 (12) Other 2 (3) Thiazide diuretics 7 (12) Heart failure 6 (10) Hypovolemia 6 (10) Kidney disease 4 (7) Adrenal insufficiency 2 (3) Cirrhosis 1 (2) Other therapies for hyponatremia, N (%) Fluid restriction 51 (88) Sodium chloride tablets 22 (38) Loop diuretics 19 (33) Normal saline 12 (21) Vasopressin antagonists 6 (10) Hypertonic saline 3% 4 (7) Potassium chloride tablets 3 (5) Glucocorticoids 1 (2) Etiologies of hyponatremia and therapies for hyponatremia are not mutually exclusive. IQR, interquartile range; SIADH, syndrome of inappropriate antidiuretic hormone secretion.
- Table 2.
Baseline and post-treatment laboratory parameters among urea only–treated patients
Laboratory Parameter Baseline 24 h End of Therapy Plasma sodium, mEq/L 125 [122–127] 127 [124–129]; P=0.02 131 [129–136]; P=0.001 BUN, mg/dl 16 [10–20] 24 [20–35]; P=0.001 42 [26–53]; P<0.001 Serum creatinine, mg/dl 0.8 [0.75–1] 0.8 [0.75–1]; P=0.91 0.9 [0.75–1]; P=0.59 Urine osmolality, mOsm/kg 365 [361–561]a 450 [359–522.5]b; P=0.12 546 [542–602]c; P=0.13 Urine sodium, mEq/L 75 [42–105]a NA 50 [37–76]c; P=0.06 Outcome Urea-Only Treated, n=12 Urea Untreated, n=12 P Value Baseline plasma sodium 125 [122–127] 123 [121–125] NA Change in plasma sodium by 24 h, mEq/L 2.5 [0–4.5] −0.5 [−2.5 to 1.5] 0.04 Change in plasma sodium by end of therapy, mEq/L 6 [3.5–10] 5.5 [3–7.5] 0.51 Normalization of plasma sodium, N (%) 4 (33) 1 (8) 0.08 LOS, d 6 [3.5–7] 6 [4–6] 0.74 Data are presented as median [interquartile range] or N (%). NA, not applicable, because urea-treated and untreated patients were matched for baseline plasma sodium; LOS, length of hospital stay.
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Urea for the Treatment of Hyponatremia
