Europe vs USA: how to manage hyponatraemia according to guidelines?

11.15-12.00 Sunday 17 May

Dr Mark Sherlock (Republic of Ireland)

One of the highlights of the ECE2015 scientific programme is the eagerly awaited debate on the management of hyponatraemia. Hyponatraemia is the most prevalent electrolyte disorder and has long been recognised as being associated with increased morbidity and mortality. Unfortunately, the management of hyponatraemia can be challenging. 

There are two key publications which aim to standardise the management of patitents with hyponatraemia by providing clarity over the optimum management of the condition:

1. Diagnosis, evaluation, and treatment of hyponatremia: expert panel recommendations. (Predominantly USA based)
2. Clinical practice guideline on diagnosis and treatment of hyponatraemia. (European based)

While the two documents concur on a number of key topics there is a significant disagreement when it comes to the use of vasopressin receptor antagonists in the management of hyponatraemia.

These discrepancies result in practicing clinicians being left in the situation where two sets of recommendations/ guidelines generated by experts in the field have come to significantly different conclusions on how best to manage patients with hyponatraemia. 

This debate will try and enlighten the audience as to the rationale and evidence base for each of the approaches.  Ultimately, an agreed approach to this patient group is required for clinicians in practice.