UPMC Physician Resources

Take the CME Evaluation

Renal Grand Rounds Winter 2017: Urea in the Treatment of Hyponatremia

Hyponatremia, defined as a plasma sodium (PNa) concentration less than 135 mEq/L, is the most common electrolyte disorder. Hyponatremia is associated with an increased risk of mortality in hospitalized patients. It has also recently been recognized that milder, and apparently asymptomatic, forms of hyponatremia are not only associated with increased mortality, but also with an increased risk of neurocognitive deficits, gait disturbances, falls, bone fractures, and osteoporosis. Hyponatremia also is associated with significant costs to our health care system.

Educational objectives:

Upon completion of this activity, participants should be able to:

  • Describe the mechanism(s) of action of urea in hyponatremia
  • Identify advantages of the use of urea in hyponatremia
  • Identify drawbacks of the use of urea in hyponatremia

Reading Resources:

  1. Decaux G, Gankam Kengne F, Couturier B, Vandergheynst F, Musch W, Soupart A. Actual Therapeutic Indication of an Old Drug: Urea for Treatment of Severely Symptomatic and Mild Chronic Hyponatremia Related to SIADH. J Clin Med. 2014;3:1043-1049.
  2. Spasovski G, Vanholder R, Allolio B, et al. Clinical practice guideline on diagnosis and treatment of hyponatraemia. Nephrol Dial Transplant. 2014;29 Suppl 2:i1-i39.
  3. Sterns RH, Silver SM, Hix JK. Urea for hyponatremia? Kidney Int. 2015;87:268-270.


Doctor Rondon-Berrios reports no relationships with proprietary entities producing health care goods and services.

All presenters disclosure of relevant financial relationships with any entity producing, marketing, re-selling, or distributing health care goods or services, used on, or consumed by, patients is listed above.  No other planners, members of the planning committee, speakers, presenters, authors, content reviewers and/or anyone else in a position to control the content of this education activity have relevant financial relationships to disclose.

Accreditation Statement:

The University of Pittsburgh School of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The University of Pittsburgh School of Medicine designates this enduring material for a maximum of 1 AMA PRA Category .5 Credits™. Each physician should only claim credit commensurate with the extent of their participation in the activity. Other health care professionals are awarded (0.05) continuing education units (CEU) which are equivalent to .5 contact hour.

For your credit transcript, please access our website 4 weeks post-completion at http://ccehs.upmc.edu and follow the link to the Credit Transcript page. If you do not provide the last 5 digits of your SSN on the next page you will not be able to access a CME credit transcript. Providing your SSN is voluntary.

Release Date: 5/10/2014 | Last Modified On: 1/23/2017 | Expires: 1/23/2018

Additional Resources


Helbert Rondon Berrios, MD

Helbert Rondon Berrios, MD Location(s):
University of Pittsburgh Physicians
Renal-Electrolyte Division
University Center (UPMC Kidney Clinic)
120 Lytton Ave.
Suite 300
Pittsburgh, PA 15213
Office Phone: (412) 802-3043
View Full Profile