ArticleA Prospective Comparison Study on the Effectiveness Of 3% Saline and Tolvaptan in Hyponatremia
Amala T.A* , Dr. Vikas P.V, , Dr. Haris Mohamed K.M, , Aleena Anna John, , Sreeja P.A
Hyponatremia is defined as the serum sodium concentration is less than 135 meq . Hyponatremia is the most noticeable electrolyte abnormality in hospitalized patients, which may lead to seizures, prolonged hospitalization and result in an increased rate of mortality. The treatment of hyponatremia is contentious since it was found in the early 1980s that rapid correction of hyponatremia can lead to central pontine myelinolysis and hyponatremia can cause brain damage if not corrected rapidly . Moreover, current studies proved that tolvaptan can improve the treatment outcomes of hyponatremia patient suffering from acute and chronic heart failure, liver disease and end-stage kidney disease This is a prospective observational study was conducted for a period of three months at a tertiary care teaching hospital. Hyponatremia were found in some patients at the time of admission as well as in the hospital stay. Based on volume status of the patient, all the patients are treated with 3% NaCl and Tolvaptan. 100 ml of 3 % saline or 15 mg of Tolvaptan was given for the identified population .In 377 number of patients monitored, 79 patients have found sodium level less than 135 meq/l. . By comparing the efficacy in increasing serum sodium level, NaCl proved to be more effective than tolvaptan, but on concerning safety, the patients’ treated with NaCl reported more adverse drug reactions than oral tolvaptan. The major drawback of our study was the limited sample size and not monitoring the serum sodium level at 72hrs and urine osmolality which was shown to have an importance in selecting the choice of treatment to prove the efficacy.The hypertonic saline as well as arginine vasopressin inhibitor Tolvaptan are effective in correcting hyponatremia. They are selected based on the fluid characteristics of the patients. In spite of the infusion site reactions the hyponatremia correction rate was more with 3 % saline compared to Tolvaptan.