{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T04:59:58Z","timestamp":1792213198416,"version":"4.4.0"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2023,3,7]],"date-time":"2023-03-07T00:00:00Z","timestamp":1678147200000},"content-version":"vor","delay-in-days":5,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,3,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Current guidelines recommend treating symptomatic hyponatremia with rapid bolus-wise infusion of fixed volumes of hypertonic saline regardless of body weight. We hypothesize that this approach is associated with overcorrection and undercorrection in patients with low and high body weight.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Single-center, retrospective cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data were collected on patients treated with \u22651 bolus 100 or 150\u2005mL 3% NaCl for symptomatic hyponatremia between 2017 and 2021. Outcomes were overcorrection (plasma sodium rise &amp;gt; 10\u2005mmol\/L\/24\u2005h, &amp;gt; 18\u2005mmol\/L\/48\u2005h, or relowering therapy) and undercorrection (plasma sodium rise &amp;lt; 5\u2005mmol\/L\/24\u2005h). Low body weight and high body weight were defined according to the lowest (\u226460\u2005kg) and highest (\u226580\u2005kg) quartiles.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Hypertonic saline was administered to 180 patients and caused plasma sodium to rise from 120\u2005mmol\/L to 126.4\u2005mmol\/L (24\u2005h) and 130.4\u2005mmol\/L (48\u2005h). Overcorrection occurred in 32 patients (18%) and was independently associated with lower body weight, weight \u2264 60\u2005kg, lower baseline plasma sodium, volume depletion, hypokalemia, and less boluses. In patients without rapidly reversible causes of hyponatremia, overcorrection still occurred more often in patients \u2264 60\u2005kg. Undercorrection occurred in 52 patients (29%) and was not associated with body weight or weight \u2265 80\u2005kg but was associated with weight \u2265 100\u2005kg and lean body weight in patients with obesity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our real-world data suggest that fixed dosing of bolus hypertonic saline may expose patients with low and high body weight to more overcorrection and undercorrection, respectively. Prospective studies are needed to develop and validate individualized dosing models.<\/jats:p><\/jats:sec>","DOI":"10.1093\/ejendo\/lvad028","type":"journal-article","created":{"date-parts":[[2023,3,6]],"date-time":"2023-03-06T22:22:45Z","timestamp":1678141365000},"page":"322-330","source":"Crossref","is-referenced-by-count":19,"title":["Overcorrection and undercorrection with fixed dosing of bolus hypertonic saline for symptomatic hyponatremia"],"prefix":"10.1093","volume":"188","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0143-4121","authenticated-orcid":false,"given":"Anissa","family":"Pelouto","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Erasmus Medical Center, University Medical Center Rotterdam , PO Box 2040, Room Ns403, 3000 CA Rotterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3040-4685","authenticated-orcid":false,"given":"Julie C","family":"Refardt","sequence":"additional","affiliation":[{"name":"Departments of Endocrinology, Diabetology and Metabolism University Hospital Basel , Basel , Switzerland"},{"name":"Department of Clinical Research, University Hospital Basel, University of Basel , Basel , Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6336-0965","authenticated-orcid":false,"given":"Mirjam","family":"Christ-Crain","sequence":"additional","affiliation":[{"name":"Departments of Endocrinology, Diabetology and Metabolism University Hospital Basel , Basel , Switzerland"},{"name":"Department of Clinical Research, University Hospital Basel, University of Basel , Basel , Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrienne A M","family":"Zandbergen","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Erasmus Medical Center, University Medical Center Rotterdam , PO Box 2040, Room Ns403, 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