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Rapid correction of severe hyponatremia traditionally has been feared due to risk for osmotic demyelination syndrome (ODS). But a recent meta-analysis challenged the traditional view, showing that too-slow correction was associated with longer hospital length of stay and excess in-hospital mortality (NEJM JW Gen Med Dec 15 2024 and JAMA Intern Med 2025; 185:38). Now, Swedish researchers have provided additional data with this study of 7600 hospitalized adults with severe hyponatremia (sodium concentrations <125 mEq/L); about half had 24-hour sodium correction rates ≤8 mEq/L, and half had rates >8 mEq/L.
Key results were as follows:
Only 7 patients (0.09%) developed ODS, 6 of whom had correction rates >8 mEq/L/24 hours.
Three of these patients …