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UPMC Physician Presents Poster on Treatment of Inpatient Hyponatremia Using Urea at National Kidney Foundation’s 2018 Spring Clinical Meetings

May 3, 2018
According to study findings presented at the National Kidney Foundation’s 2018 Spring Clinical Meetings, held in April, treatment of inpatient hyponatremia with a novel American formulation of urea is safe and effective. 

Helbert Rondon-Berrios, MD, associate professor of medicine in the renal-electrolyte division at the University of Pittsburgh School of Medicine, and colleagues, facilitated this study which included 58 hospitalized patients with hyponatremia (plasma sodium level below 135 mEq/L). Each patient was treated with a new formulation of urea, among other therapies. The median age of these patients was 67.5 years, and 35 patients (60 percent) were male. Each patient received urea at a dosage of 7.5 to 90 g/day for a median duration of 4.5 days.

Among patients in this cohort, the investigators found 14 patients who received urea as the sole drug therapy for hyponatremia (cases) and matched them 1:1 to 14 hyponatremic patients hospitalized in the prior year and who did not receive urea treatment (controls). The investigators matched cases and controls by sex, etiology, and degree of hyponatremia.

Urea therapy was associated with a significant increase in median plasma sodium level in the entire cohort. A significantly greater proportion of cases achieved a normal plasma sodium level than controls. The investigators observed no significant difference in the change in plasma sodium levels at the end of therapy or in length of hospital stay in cases compared with controls.

In the entire cohort of patients who received urea, the researchers observed no episodes of overcorrection of plasma sodium and no adverse events associated with the use of urea. They noted that one patient discontinued urea as a result of poor palatability. Dr. Rondon-Berrios and his colleagues noted that the study was limited by retrospective design, small sample size, and a relatively short duration of urea therapy.

“The significance of this study relates to the finding that a novel formulation of urea now available for use in the United States appears to be effective and safe for the management of inpatient hyponatremia, and is well tolerated by patients,” said Dr. Rondon-Berrios.