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Treating Hyponatremia: What Is All the Controversy About?

Tomas Berl, MD
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Requests for Reprints: Tomas Berl, MD, C281, University of Colorado School of Medicine, 4200 East 9th Avenue, Denver, CO 80262.

University of Colorado School of MedicineDenver, CO 80262

Ann Intern Med. 1990;113(6):417-419. doi:10.7326/0003-4819-113-6-417
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Few subjects consistently engender as much heated discussion as the treatment of hyponatremia. The confusion surrounding this subject is also evident from perusal of the medical literature. Whereas some authorities emphasize the catastrophic consequences associated with the failure to treat the symptomatic patient with this disorder (1-5), others point to the equally catastrophic outcome that can accompany treatment (6-10). What should a physician do when confronted with this seemingly irreconcilable dilemma? Understanding the cerebral consequences of untreated and treated hyponatremia, as well as awareness of the clinical settings that increase the risks for developing neurologic damage, can lead to a




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