SynthesisBMJ open2021
Clinical characteristics and outcomes of hyponatraemia associated with oral water intake in adults: a systematic review.
Synthesis in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
15 citing papers in PubMed, 33 citations in OpenAlex.
- Rehydration effect of qingshu buye decoction on exercise and high temperature-induced dehydration.Journal of the International Society of Sports Nutrition · 2024Trial
- Psychogenic polydipsia in dogs - a review of pathogenesis, diagnosis and treatment.The Journal of small animal practice · 2026Review
- Treatment of Autosomal Dominant Polycystic Kidney Disease: Integrating Clinical Practice Guidelines, Patient Perspectives, and Real-World Effectiveness.Journal of the American Society of Nephrology : JASN · 2026Review
- Osmolality (mosmol/kg HEuropean journal of medical research · 2025Review
- Article
- Flexible value coding in the mesolimbic dopamine system depending on internal water and sodium balance.NPJ science of food · 2025Article
- Serum sodium within the normal range and its U-shaped relationship with biological aging in U.S. adults.Frontiers in nutrition · 2025Article
- Primary Polydipsia in a Case of Genetic Behavioral Variant Frontotemporal Dementia.The Journal of neuropsychiatry and clinical neurosciences · 2025Article
- Long-term health outcomes associated with hydration status.Nature reviews. Nephrology · 2024Review
- Article
- A century of exercise physiology: concepts that ignited the study of human thermoregulation. Part 3: Heat and cold tolerance during exercise.European journal of applied physiology · 2024Review
- Hyponatremia Demystified: Integrating Physiology to Shape Clinical Practice.Advances in kidney disease and health · 2023Review
- Inappropriate therapy of euvolemic hyponatremia, the most frequent type of hyponatremia in SARS-CoV-2 infection, is associated with increased mortality in COVID-19 patients.Frontiers in endocrinology · 2023Article
- Observational Study of the Association between Hyponatremia and Rhabdomyolysis in Patients Presenting to Hospital.Journal of clinical medicine · 2022Article
- High Urinary Sodium Concentrations in Severe SIADH: Case Reports of 2 Patients and Literature Review.Frontiers in medicine · 2022Article
Corrections and comments
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Authors and funding
12 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionExcessive water intake is rarely associated with life-threatening hyponatraemia. The aim of this study was to determine the clinical characteristics and outcomes of hyponatraemia associated with excess water intake.
methodsThis review was conducted using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. All studies (case reports, observational or interventional studies) reporting excess water intake and hyponatraemia in adults (1946-2019) were included.
resultsA total of 2970 articles were identified and 177 were included (88.7% case reports), consisting of 590 patients. The mean age was 46±16 years (95% CI 44 to 48 years), 47% female, 52% had a chronic psychiatric disorder and 31% had no underlying condition. The median volume of water consumed and serum sodium at presentation was 8 L/day (95% CI 8.9 to 12.2 L/day) and 118 mmol/L (95% CI 116 to 118 mmol/L), respectively. The motivator for increased water consumption was psychogenic polydipsia (55%); iatrogenic (13%); exercise (12%); habitual/dipsogenic polydipsia (7%) and other reasons (13%). The clinical features on presentation were severe in 53% (seizures, coma); moderate in 35% (confusion, vomiting, agitation) and mild in 5% (dizziness, lethargy, cognitive deficit) and not reported in 5% of studies. Treatment was supportive in 41% of studies (fluid restriction, treatment of the underlying cause, emergency care), and isotonic and hypertonic saline was used in 18% and 28% of cases, respectively. Treatment-related complications included osmotic demyelination (3%) and rhabdomyolysis (7%), and death occurred in 13% of cases.
conclusionWater intoxication is associated with significant morbidity and mortality and requires daily intake to substantially exceed population-based recommendations. The limitations of this analysis are the low quality and high risk of bias of the included studies. PROSPERO REGISTRATION NUMBER: A pre-existing protocol in the international prospective register of systematic reviews was updated to incorporate any new amendments and reregistered at http://www.crd.york.ac.uk/PROSPERO (registration no. CRD42019129809).
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.