Clinical characteristics and outcomes of hyponatraemia associated with oral water intake in adults: a systematic review
Rangan GK, Dorani N, Zhang MM, Abu-Zarour L, Lau HC, Munt A, Chandra AN, Saravanabavan S, Rangan A, Zhang JQJ, Howell M, Wong AT
BMJ open · 26 citas
Etiquetas de revisión
Vínculos de autores con la industriaDatos neutrales que nuestra revisión registró sobre cómo se hizo este estudio. Describen el método, nunca si nos gusta el resultado.
Cómo se estudió
- Diseño
- Revisión sistemática (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Eventos clínicos como enfermedad o muerte
Quién lo pagó
- Financiación
- Financiación independiente
- Universidad u hospital
- Western Sydney Local Health District
- Universidad u hospital
- University of Sydney
- Organización sin fines de lucro
- PKD Australia
- Gobierno
- Medical Research Council
- Gobierno
- National Health and Medical Research Council
- Autores
- Al menos un autor declara un vínculo económico con la industria
- Subvenciones
- National Health and Medical Research Council (1138533); National Health and Medical Research Council (1164128)
Según 5 financiadores declarados y la declaración de financiación del texto completo.
Publicación
- Publicado
- 2021-12-01 · BMJ Open · vol. 11 · número 12 · pág. e046539
- Editorial
- BMJ
- Citado
- 36 citas · más que el 81% de estudios similares · 1.3× el promedio de su campo
- Referencias
- 243 trabajos
- Acceso
- Acceso abierto (revista) · CC-BY-NC
- Áreas de investigación
- Electrolyte and hormonal disorders · Thermoregulation and physiological responses · Sodium Intake and Health
- Palabras clave
- Medicine, Epidemiology, Intensive care medicine, Public health, MEDLINE, Environmental health, Internal medicine, Pathology
- MeSH
- humans, hyponatremia, chronic disease, water, saline solution, hypertonic, drinking, adult, middle aged, female, male
12 autores
- Gopala K. Rangan🇦🇺 · autor de correspondenciaWestmead Hospital; Westmead Institute for Medical Research
- Nilofar Dorani🇦🇺The University of Sydney; Westmead Institute for Medical Research
- Miranda M. Zhang🇦🇺The University of Sydney; Westmead Institute for Medical Research
- Lara Abu-Zarour🇦🇺The University of Sydney; Westmead Institute for Medical Research
- Ho Ching Lau🇦🇺The University of Sydney; Westmead Institute for Medical Research
- Alexandra Munt🇦🇺Westmead Hospital; Westmead Institute for Medical Research
- Ashley N. Chandra🇦🇺Westmead Hospital; Westmead Institute for Medical Research
- Sayanthooran Saravanabavan🇦🇺Westmead Institute for Medical Research
- Anna Rangan🇦🇺The University of Sydney
- Jennifer Q. J. Zhang🇦🇺Westmead Hospital; Westmead Institute for Medical Research
- Martin Howell🇦🇺The University of Sydney
- Annette T. Y. Wong🇦🇺Westmead Hospital; Westmead Institute for Medical Research
Resumen
El texto original del estudio, en el idioma en que se publicó.
Introduction
Excessive water intake is rarely associated with life-threatening hyponatraemia. The aim of this study was to determine the clinical characteristics and outcomes of hyponatraemia associated with excess water intake.
Methods
This review was conducted using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. All studies (case reports, observational or interventional studies) reporting excess water intake and hyponatraemia in adults (1946-2019) were included.
Results
A total of 2970 articles were identified and 177 were included (88.7% case reports), consisting of 590 patients. The mean age was 46±16 years (95% CI 44 to 48 years), 47% female, 52% had a chronic psychiatric disorder and 31% had no underlying condition. The median volume of water consumed and serum sodium at presentation was 8 L/day (95% CI 8.9 to 12.2 L/day) and 118 mmol/L (95% CI 116 to 118 mmol/L), respectively. The motivator for increased water consumption was psychogenic polydipsia (55%); iatrogenic (13%); exercise (12%); habitual/dipsogenic polydipsia (7%) and other reasons (13%). The clinical features on presentation were severe in 53% (seizures, coma); moderate in 35% (confusion, vomiting, agitation) and mild in 5% (dizziness, lethargy, cognitive deficit) and not reported in 5% of studies. Treatment was supportive in 41% of studies (fluid restriction, treatment of the underlying cause, emergency care), and isotonic and hypertonic saline was used in 18% and 28% of cases, respectively. Treatment-related complications included osmotic demyelination (3%) and rhabdomyolysis (7%), and death occurred in 13% of cases.
Conclusion
Water intoxication is associated with significant morbidity and mortality and requires daily intake to substantially exceed population-based recommendations. The limitations of this analysis are the low quality and high risk of bias of the included studies.
Prospero registration number
A pre-existing protocol in the international prospective register of systematic reviews was updated to incorporate any new amendments and reregistered at http://www.crd.york.ac.uk/PROSPERO (registration no. CRD42019129809).
Resumen vía Europe PMC. Los derechos de autor siguen siendo de los autores o la editorial (CC BY-NC).
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