Treatment of Hyponatremia

Excerpt

To the Editors: I read with great anticipation the editorial on hyponatremia by Dr. Berl (1) but was again disappointed with the guidelines for treatment. Experts in the field have written a profusion of articles on hyponatremia (2, 3). To "clarify" treatment, I would like to show what a blow-by-blow comparison looks like:

Acute (<24 h) symptomatic hyponatremia: Berl (1): "Correcting hyponatremia of shorter duration carries no untoward consequences regardless of the treatment regimen . . . acute symptomatic hyponatremia should be treated promptly." Sterns (2): "When the clinical situation demands it, correction can be safely initiated at 1 to