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Guidelines on Hyponatraemia have been published
Weimar, Germany (March 4, 2014) – Guidelines for diagnosing and treating hyponatraemia, a salt imbalance occurring in up to 30% of hospitalised patients, have recently been published simultaneously in three journals: the full guidelines are available online without charge from "Nephrology, Dialysis and Transplantation", the official Journal of the European Renal Association-European Dialysis and Transplant Association (ERA-EDTA), from the "European Journal of Endocrinology", the official journal of the European Society of Endocrinology (ESE), and also from "Intensive Care Medicine", the official journal of the European Society of Intensive Care Medicine (ESICM). "This underlines the importance and impact of the guideline, which was developed in collaboration between these three societies", explains Prof. Dr. Raymond Vanholder (Ghent, Belgium), president of the ERA-EDTA. The joint guideline group has conducted a strict systematic literature review with the assistance of the Methodological Support Team of European Renal Best Practice (ERBP), the guidance body of ERA-EDTA, to collect the best available evidence on the diagnosis and management of hypotonic hyponatraemia. The new guidelines were developed on this robust basis of evidence.
Hyponatraemia is a complicated disorder of water balance, with a relative excess of body water compared to sodium and potassium (defined as a serum sodium concentration <135 mmol/l). It has a wide variety of underlying causes, and results in cellular swelling (resulting in cerebral oedema). It is associated with increased mortality, while its treatment, if performed inappropriately, also may result in serious complications. Hyponatraemia can occur in patients with kidney disease due to an elevated water retention and/or to increased sodium excretion – these are some of the reasons why nephrologists were involved in the guideline development.
The new guidelines advise a pathway for diagnosis which can be conducted in the general hospital setting and focus more closely on the patients’ symptoms, giving lower priority to biochemical diagnosis. "That makes them very practice-oriented", emphasises Vanholder. Next to a description of the patho-physiologic basis and a comprehensive rationale of the guidelines, the monograph also contains a number of didactic flow-charts, stepwise depicting the diagnostic and therapeutic interventions, which makes this document extremely suitable at the bedside for the practicing clinician.
With more than 6,600 members, the ERA-EDTA ("European Renal Association – European Dialysis and Transplant Association") is one of the biggest nephrology associations worldwide and one of the most important and prestigious European Medical Associations. It supports basic and clinical research in the fields of clinical nephrology, dialysis, renal transplantation and related subjects. The ERA-EDTA supports a number of studies as well as research groups and has founded a special "Fellowship Programme" for young investigators as well as grant programmes. In order to involve young nephrologists in all activities of the ERA-EDTA the Council decided to create a Young Nephrologists’ Platform (YNP). Besides, it has established various research networks and different working groups to promote the collaboration of nephrologists with other medical disciplines (e.g. cardiology, immunology). Furthermore, a "European Renal Best Practice" (ERBP) advisory board has been established by the ERA-EDTA to draw up and publish guidelines and position statements. Another important goal of the ERA-EDTA is education: several series of CME-courses as well as the annual congress offer an attractive scientific programme to cover the need of continuous medical education for doctors working in the fields of nephrology, dialysis and transplantation. The association’s journals, NDT (Nephrology, Dialysis, Transplantation) and CKJ (Clinical Kidney Journal), are currently the leading nephrology journals in Europe. The ERA-EDTA Registry is a large epidemiologic database comparing countries by assessing nephrology practice throughout Europe. Finally, ERA-EDTA is member of the European Kidney Health Alliance (EKHA), a consortium of renal societies that actively interacts with the European Parliament. For more information please visit www.era-edta.org
European Renal Association – European Dialysis and Transplant Association, 04.03.2014 (tB) Thomas Backe