Consensus document on the management of hyponatraemia of the Acqua Group of the Spanish Society of Endocrinology and Nutrition

Hyponatremia is the most prevalent electrolyte disorder in the outpatient and inpatient settings. Despite this frequency, hyponatremia, including severe hyponatremia, is frequently underestimated and inadequately treated, thus highlighting the need to produce consensus documents and clinical practice guidelines geared towards improving the diagnostic and therapeutic approach to it in a structured fashion. Members of the Acqua Group of the Spanish Society of Endocrinology and Nutrition (SEEN) met using a networking methodology over a period of 20 months (between October 2019 and August 2021) with the aim of discussing and developing an updated guideline for the management of hyponatraemia. A literature search of the available scientific evidence for each section presented in this document was performed. A document with 8 sections was produced, which sets out to provide updated guidance on the most clinically relevant questions in the management of hyponatraemia. The management of severe hyponatraemia is based on the i.v. administration of a 3% hypertonic solution. For the management of chronic euvolemic hyponatraemia, algorithms for the initiation of treatment with the two pharmacological therapeutic options currently available in Spain are presented: urea and tolvaptan. This document sets out to simplify the approach to and the treatment of hyponatraemia, making it easier to learn and thus improve the clinical approach to hyponatremia. La hiponatremia es el trastorno electrolítico más prevalente tanto en medio ambulatorio como hospitalario. A pesar de esta frecuencia, la hiponatremia, incluso la grave, es frecuentemente infravalorada e inadecuadamente tratada, lo que pone de manifiesto la necesidad de elaborar documentos de consenso y guías de práctica clínica orientadas a mejorar su abordaje diagnóstico y terapéutico de forma estructurada. Miembros del Grupo Acqua de la Sociedad Española de Endocrinología y Nutrición (SEEN) se reunieron mediante una metodología de trabajo en red durante un periodo de 20 meses (entre Octubre de 2019 y Agosto de 2021), con la finalidad de discutir y elaborar una guía actualizada para el manejo de la hiponatremia. Se realizó una búsqueda bibliográfica de la evidencia científica disponible para cada apartado expuesto en el presente documento. Se ha elaborado un documento que a través de 8 secciones pretende resolver la mayoría de las preguntas en el manejo clínico de la hiponatremia. El manejo de la hiponatremia grave se basa