Overcorrection of severe hyponatremia, osmotic demyelination syndrome, and mortality: insights from two Brazilian centers.

ABSTRACT:

Introduction

Severe hyponatremia (sodium ≤ 120 mmol/L) poses significant clinical risks, including encephalopathy and seizures, but inadvertent rapid correction may cause osmotic demyelination syndrome (ODS). Current guidelines recommend limiting sodium correction to ≤8 mmol/L per 24 hours to minimize ODS risk. However, recent studies suggest that overcorrection may not directly contribute to mortality and could even be associated with improved outcomes.

Methods

This retrospective cohort study included 362 patients with severe hyponatremia admitted to two Brazilian tertiary hospitals. Overcorrection was defined as a serum sodium increase >8 mmol/L in 24 hours or >18 mmol/L in 48 hours. Multivariate logistic regression and propensity score-weighted analyses were used to ident

SUBMITTER: Reis LAC 

PROVIDER: S-EPMC12854713 | biostudies-literature | 2026 Jan-Mar

REPOSITORIES: biostudies-literature