Outcomes of hospitalized patients with severe hyponatremia: findings from the pilot of HypoNa-RESCUE, a multicentre observational study

Sam Solanki; Chandran Alexander Palapatti; Jie Yee Amanda Ling; Samama Rafi; Aspasia Manta; Azheem Ijaz; Aravind Manoj; Ahmed Iqbal; Arshad Muhammad Fahad; Punith Kempegowda

doi:10.1530/endoabs.117.P182

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Endocrine Abstracts (2026) 117 P182 | DOI: 10.1530/endoabs.117.P182

SFEBES2026 Poster Presentations Neuroendocrinology and Pituitary (40 abstracts)

Outcomes of hospitalized patients with severe hyponatremia: findings from the pilot of HypoNa-RESCUE, a multicentre observational study

Sam Solanki ¹ , Alexander Palapatti Chandran ¹ , Amanda Ling Jie Yee ^2,3 , Samama Rafi ^2,3 , Aspasia Manta ³ , Azheem Ijaz ⁴ , Aravind Manoj ^1,4 , Ahmed Iqbal ^1,4 , Muhammad Fahad Arshad ^1,4 & Punith Kempegowda ^2,3

Author affiliations

¹Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom; ²University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom; ³University of Birmingham, Birmingham, United Kingdom; ⁴The University of Sheffield, Sheffield, United Kingdom

Background: Hyponatremia guidelines recommend limiting of sodium correction rate to prevent osmotic demyelination syndrome (ODS). However, emerging evidence suggests ODS is rare, and rapid sodium correction is associated with reduced mortality. There is currently no standardized surveillance system to detect ODS. We set up a multicentre surveillance model to explore trends in severe hyponatremia management. Using data from this, we compared length of hospital stay (LOS) between patients who underwent rapid (>10mmol/l/24 hours) and slow correction (≤10mmol/l/24 hours).

Methods: A multicentre observational retrospective study was conducted from January-May 2025 across two tertiary UK hospitals. Patients admitted with severe hyponatremia (serum sodium<125mmol/l) from January-December 2024 were included. Through expert consensus, we established a surveillance system called HypoNa-RESCUE (Understanding Trends in Hyponatremia Management through Rapid Evaluation and Surveillance of Critical Urgencies in Endocrinology Model) to facilitate data collection. Data on demographics, precipitating factors, management, and outcomes of hyponatremia were collected. Data were analysed using SPSS and presented as appropriate in frequency or median and interquartile range [IQR].

Results: A total of 767 admissions were included in pilot analysis with a baseline median age of 71.0 [IQR, 61.0-81.0] years, and Charlson Comorbidity index of 4.0 [3.0-5.0]. Most common aetiology for severe hyponatremia was drug-induced (21.4%). Most patients were asymptomatic (65.6%). Median sodium on admission was 121 [118-123] mmol/l, increasing to 130 [125-134] mmol/l at discharge. Hypertonic saline was used in 2.3% of admissions, and 4.7% were managed in intensive care. 45 (8.9%) patients had rapid correction, and 458 (91.1%) had slow correction. There was no significant difference in median LOS between rapid vs slow correction (7.0 [3.3-15.0] vs. 6.0 [3.0-14.0] days, P = 0.496).

Conclusion: Pilot data suggest that either correction strategy did not affect LOS. Future work will explore differences in mortality and frequency of ODS, which may inform prospective trials.