Hyponatremia Correction and Osmotic Demyelination Syndrome Risk: A Systematic Review and Meta-Analysis
Supawadee Suppadungsuk, Pajaree Krisanapan, Sara Kazeminia, Nasrin Nikravangolsefid, Waryaam Singh, Larry J. Prokop, Kianoush Kashani, Juan Pablo Domecq Garces
Abstract
Rationale & Objective: Osmotic demyelination syndrome (ODS) is a rare but severe condition often attributed to the rate of sodium collection. We evaluated the association between the overly rapid sodium correction in adult hospitalized patients with ODS. Study Design: Systematic review and meta-analysis. Setting & Study Populations: Adults hospitalized hyponatremia patients. Selection Criteria for Studies: The studies comparing the incidence of ODS with and without rapid sodium correction inception to January 2024. Data Extraction: Two reviewers independently extracted data and assessed the risk of bias and the certainty of evidence. Analytic Approach: The incidence of ODS following a rapid and nonrapid sodium correction was pooled using the random effects model. Subgroup and meta-regression analyses were performed for the robustness and the source of heterogeneity. Results: = 27%), whereas some patients with hyponatremia developed ODS without rapid sodium level correction. The sensitivity analysis based on the quality of the studies was consistent with the main result. Limitation: Various definition criteria for ODS diagnosis across studies, lack of potential electrolyte and treatment data that may affect the incidence of ODS. Conclusions: The rapid rate of sodium correction had a statistical correlation with a higher incidence of ODS. Among ODS without rapid correction, further studies are recommended to evaluate and comprehend the relationship for better and proper management of hospitalized patients with hyponatremia.