Hyponatremia and 40 Years of Controversy: Looking Back and Moving Forward traces and probes the prolonged, contentious debate surrounding the treatment of severe hyponatremia, a low-sodium concentration in the blood that can result in severe brain damage if managed incorrectly.
A mix of memoir and science, the book explains how slow correction of hyponatremia became accepted and how consensus was disrupted by assertions that caution was unnecessary and harmful. It scrutinizes the controversy, offers an approach to management, and unpacks research limitations - reminding us that what is believed true today may change tomorrow.
Hyponatremia and 40 Years of Controversy: Looking Back and Moving Forward is a vital resource for both experienced medical specialists and novice trainees. It explains the physiology of how hyponatremia happens and how it hurts. By offering historical insights, scientific rigor, and practical guidance, this book promises to enhance clinical decision making, foster new research, and improve outcomes in patients with hyponatremia.
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Table of Contents
PART ONE: Salt, Science, Serendipity, and Strife1. From central pontine myelinolysis (CPM) to osmotic demyelination syndrome (ODS)
2. What’s rapid correction?
3. Osmotic stress and demyelination
4. Hyponatremic Encephalopathy: Age, Sex, Hormones and Oxygen
5. Speed Limits and How to Obey Them
PART TWO: Climbing the ladder and finding the ground
6. New Evidence: Rare or just not well done?
7. The Court’s in Session
8. Primum non nocere
9. Beyond osmosis: malnutrition, alcoholism, and the liver
10. A toolbox for managing hyponatremia
Authors
Richard H. Sterns University of Rochester School of Medicine and Dentistry and Rochester General Hospital, USA.Richard H. Sterns is a nephrologist, a Professor Emeritus at the University of Rochester School of Medicine and Dentistry, a former Chief of Medicine at Rochester General Hospital, and an Editor-in-Chief for Fluid and Electrolytes for UpToDate. Dr. Sterns is a graduate of Stanford University who completed his medical degree at the University of Pennsylvania; internal medicine training at the University of California San Francisco Medical Center and Albert Einstein School of Medicine; and his nephrology fellowship at the University of Pennsylvania. Dr. Sterns introduced the term "Osmotic Demyelination Syndrome� (a serious neurological complication caused by overly rapid correction of hyponatremia) in 1986 and has published extensively on the subject of hyponatremia.
