From the Research
Urea should be administered at a median dose of 30 g/day to effectively treat hyponatremia, as evidenced by a significant increase in serum sodium levels 1. When managing hyponatremia, it is crucial to consider the underlying cause and fluid volume status of the patient.
- The approach to treating hyponatremia should involve addressing the underlying cause, and urea can be an effective treatment option for patients with the syndrome of inappropriate antidiuresis and hyponatremia, particularly in those with heart failure 2.
- Urea works by increasing urinary water excretion, thereby helping to correct serum sodium levels.
- The efficacy and safety of urea in treating chronic hyponatremia have been demonstrated in several studies, including a retrospective cohort study that showed a significant increase in serum sodium levels after urea administration 1.
- It is essential to monitor patients for signs of overcorrection, such as serum sodium levels increasing by more than 8 mEq/L in 24 hours, to minimize the risk of osmotic demyelination 2.
- In addition to its use in treating hyponatremia, urea has been shown to reduce intracranial pressure in patients with acute brain injury and hyponatremia, independent of changes in sodium levels 3.
- However, urea administration can also lead to hypernatraemia due to osmotic diuresis, particularly in critically ill patients, highlighting the need for careful monitoring of serum sodium levels and fluid balance 4.
- Overall, urea can be a valuable treatment option for hyponatremia, but its use should be guided by careful consideration of the patient's underlying condition, fluid volume status, and potential risks, as supported by the most recent and highest quality study available 1.