Key result
Patients with chronic non profound hyponatremia performed significantly worse in neurocognitive subtests than healthy volunteers (alertness P=0.018), which improved after 14 days of treatment.
Why the study?
Does short-term treatment of chronic non-profound hyponatremia improve neurocognitive and neuromuscular function in asymptomatic patients?
Case-Control (n=19)
No
Does short-term treatment of chronic non-profound hyponatremia improve neurocognitive and neuromuscular function in asymptomatic patients?
p-value: p=0.018
Short-term treatment of chronic non-profound hyponatremia improves clinical symptoms and neurocognitive function, suggesting a therapeutic benefit even in patients without clinically apparent symptoms.
Treatment was associated with short-term symptom and cognitive gains; leaves open long-term neuromuscular or outcome benefits pending larger trials.
BACKGROUND: Chronic hyponatremia is common and associated with increased morbidity and mortality. However, whether treatment improves outcome in patients without significant symptoms is unclear. We here assessed the therapeutic outcome on clinical symptoms, neurocognitive and neuromuscular function in patients with chronic non profound hyponatremia. MATERIAL AND METHODS: Prospective case-control study in 19 patients from the University Hospital Würzburg with chronic non profound hyponatremia without clinically apparent symptoms. At baseline and after a 14-day treatment period of hyponatremia, patients were assessed by specific clinical symptoms questionnaire, neurocognitive and neuromuscular function was analysed by five attention tests and a gait test consisting of 3 steps "in tandem." The results were compared to a control group of healthy volunteers. RESULTS: Compared to healthy volunteers, patients with mild (n = 10, mean serum sodium 132 ± 1.2 mmol/L) and moderate hyponatremia (n = 9, mean 126 ± 3.3 mmol/L) performed significantly worse in the neurocognitive subtests alertness (P = 0.018), divided attention (P = 0.017) and go/no-go (P = 0.026). Performance in the neuromuscular subtests was also lower in the patient group without reaching significance. The extent of hyponatremia had no impact on the specific test and questionnaire results. Fourteen-day treatment of hyponatremia improved clinical symptoms in all patients (P = 0.003) and neurocognitive function in sodium-normalised patients (go/no-go test, P = 0.029). CONCLUSION: Chronic hyponatremia is symptomatic and impairs neurocognitive and neuromuscular function. Short-time therapeutic intervention led to improved clinical symptoms and neurocognitive function, but had no effect on neuromuscular function. Larger trials with long-term treatment are needed to specify the therapeutic need in chronic hyponatremia.
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Refardt et al. (2018) conducted a case-control in Chronic non profound hyponatremia (n=19). Chronic non profound hyponatremia vs. Healthy volunteers was evaluated on Neurocognitive subtest alertness (p=0.018). Patients with chronic non profound hyponatremia performed significantly worse in neurocognitive subtests than healthy volunteers (alertness P=0.018), which improved after 14 days of treatment.
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