Julie Refardt, MD, PhD: Current Hyponatremia Clinical Interventions Sufficient

Targeted hyponatremia correction did not improve 30-day mortality and rehospitalization rates, supporting hyponatremia’s role as a marker of disease severity rather than a cause of worse outcomes.

These findings came out of the largest hyponatremia trial ever conducted, spanning 6 years, 2174 participants, and 9 tertiary centers across Europe. Findings from the phase 4 trial were presented at The American Society of Nephrology (ASN) Kidney Week 2024 in San Diego, California, held October 23-26, by investigator Julie Refardt, MD, PhD, clinical researcher, nephrology, Erasmus MC.

“My main message would be, don't misunderstand [the data]. It doesn't mean we do not have to treat hyponatremia. However, a targeted, more intense treatment of the hyponatremia does not have an additional benefit. I think that's important,” Refardt told HCPLive.

The trial randomized 1079 (49.6%) to the intervention and 1095 (50.4%) to the control group. In the intervention group, 641 (60.4%) patients reached normonatremia, compared to 493 (46.2%) patients in the control group. However, the intervention did not have any impact on 30-day clinical outcomes, with death or rehospitalization occurring in 93 (8.6%) and 138 (13.0%) patients, respectively, in the intervention group, compared to 93 (8.5%) and 151 (14.0%) patients, respectively, in the control group, for similar combined event rates of 21.0% in the intervention group and 22.2% in the control group.

“Because we only looked at it now in hospitalized patient, we cannot say is this also true for the outpatient setting. So maybe, if we can normalize hyponatremia there, maybe that will have an effect on these hard end points. So, this would be a study we would like to do,” Refardt said.

REFERENCE

Refardt J, Potasso L, Monnerat S, et al. Impact of Targeted Hyponatremia Correction on 30-Day Mortality and Rehospitalization Rate. Presented at: ASN Kidney Week 2024; San Diego, California; October 23-26.