439 Clinical Predictors for Saline Responsive Non-Edematous Hyponatremia among Hospitalized Patients Copy Right@ Bancha Satirapoj This work is licensed under Creative Commons Attribution 4.0 License AJBSR.MS.ID.001549. American Journal of Biomedical Science & Research www.biomedgrid.com --------------------------------------------------------------------------------------------------------------------------------- ISSN: 2642-1747 Research Article Naowanit Nata, Nardtaya Sriburin, Amnart Chaiprasert, Ouppatham Supasyndh and Bancha Satirapoj* Department of Medicine, Phramongkutklao Hospital and College of Medicine, Thailand *Corresponding author: Bancha Satirapoj, 315, Division of Nephrology, Department of Medicine, Phramongkutklao Hospital and Col- lege of Medicine, Bangkok 10400, Thailand. To Cite This Article: Naowanit Nata, Nardtaya Sriburin, Amnart Chaiprasert, Ouppatham Supasyndh, Bancha Satirapoj, Clinical Predic- tors for Saline Responsive Non-Edematous Hyponatremia among Hospitalized Patients. 2020 - 10(5). AJBSR.MS.ID.001549. DOI: 10.34297/ AJBSR.2020.10.001549. Received: October 13, 2020; Published: October 27, 2020 Introduction Hyponatremia is the most common of electrolyte disorders encountered in clinical practice [1] and is associated with increased morbidity, mortality and length of hospital stay among patients presenting a range of conditions [2-4]. Meta-analysis indicated that hyponatremia also relates to higher risk of re-admission and hospitalization costs [5]. Slow rate of correction in severe hyponatremia is associated with higher mortality [6]. Establishing etiology and appropriate treatment improves outcomes [7]. Clinical assessment of fluid status in the absence of diuretics, and a clinical assessment of volume status may aid further differential diagnosis. Further, treating hyponatremia depends on symptoms and etiology related to volume status of patients. An increase in plasma sodium is recommended to be limited to 10 to 12 mmol/L during the first 24 hours and to 8 mmol/L/day during the following days [8]. After hospitalization and diagnosis of hypotonic hyponatremia with no edematous patients, the physician must decide as soon as possible which treatment to choose such as saline infusion in hypovolemic hyponatremia. Volume resuscitation with isotonic saline in hyponatremia may result in an overshooting increase of plasma sodium because volume resuscitation quickly Abstract Background: Hyponatremia is one of the most common electrolyte abnormalities in hospitals. Treatment of hyponatremia depends on symptoms and etiology related to volume status of the patients. Sometime evaluating volume status of patients is difficult and challenging for the physician to decide for therapeutic of choice. Objective: This study was designed to determine the clinical and biochemical predictors for saline responsive hyponatremia. Design and participants: We conducted a clinical study among hospitalized patients with no edematous hyponatremia. The clinical and laboratory data were collected by reviews of medical records and patients were classified in 2 groups: saline responder and saline no responder. Saline responder was defined as increased serum sodium >5 mmol/L within 24 hours after saline treatment. Results: Twenty-eight patients were saline responders (49.1%), and 29 patients (50.9%) were saline no responders. The mean serum sodium at baseline and 24 hours of therapy was 125.0±3.8 and 132.0±3.8 mmol/L, respectively, in the saline responder group and 125.5±4.4 and 127.7±4.0 mmol/L, respectively, in the saline no responder group. At baseline, the saline responder group had a higher incidence of dry mucosal membrane and lower estimated glomerular filtration rate, urine sodium and urine chloride than in the saline no responder group. From multivariate analysis, presence of dry mucosa showed a strong association with saline responder (Hazard ratio 8.17 with 95% CI 1.05 to 63.39). Conclusions: Dry mucosal membrane was a strong independent predictor for saline responders among hospitalized patients with hyponatremia. Further randomized control trial should confirm the findings. Keywords: Saline responsive hyponatremia; Hyponatremia; Urine sodium; Hospitalized hyponatremia