The Adrogue-Madias Formula Revisited

[摘要] Few subjects engender as much heated discussion at various nephrology meetings as the strongly held views by advocates of various approaches to the management of hyponatremia (1). The controversy as to how these patients should best be treated can be traced to the fact that even in a specialty such as ours, which already suffers from a dearth of properly conducted prospective, randomized, controlled trials, not a single such trial is designed to address the optimal management of this most common of electrolyte disorders. There are, therefore, no clearly established and uniformly agreed-on national or international guidelines (2), and those that are put forth in various publications (2–7) are based primarily on retrospective observational analyses on a limited number of patients (7–12). None has the virtue of comparing prospectively two or more therapeutic options and monitoring for well-defined neurological outcomes in a randomized, controlled trial or even in a robust prospective, observational trial (13). Ultimately, the published recommendations are largely opinion based and reflect the experience of the various authors.

[学科分类] 泌尿医学

[关键词] Bone marrow necrosis;Sickle cell disease;Hyperhemolysis syndrome