SynthesisBMC nephrology2026
Proactive desmopressin for the prevention of serum sodium overcorrection in moderate-to-severe hyponatremia: a systematic review and meta-analysis.
Synthesis in BMC nephrology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHyponatremia is the most common electrolyte disorder in hospitalized patients and is associated with increased morbidity and mortality. Correction is challenging because rapid increases in serum sodium may lead to osmotic demyelination. Desmopressin is used to stabilize free-water excretion, but the effectiveness of proactive administration has not been systematically evaluated.
methodsWe searched PubMed-MEDLINE, Embase, and the Cochrane Library registries from inception through February 2026. We included studies enrolling adults with moderate-to-severe hyponatremia receiving standard therapy that compared proactive desmopressin with non-proactive usual-care strategies. Two reviewers independently extracted data and assessed risk of bias using ROBINS-I v2 and RoB 2. The primary outcome was serum sodium overcorrection using study-defined thresholds. Secondary outcomes included osmotic demyelination syndrome (ODS), mortality, hospital length of stay, worsening hyponatremia, and total hypertonic saline volume infused.
resultsSix studies including 1,881 patients were included, of whom 168 received proactive desmopressin. Proactive desmopressin was associated with significantly lower odds of overcorrection compared with non-proactive usual-care strategies (OR, 0.29; 95% CI, 0.19-0.45; p < 0.001; prediction interval, 0.14-0.62). This association was consistent across thresholds of > 8, >10, and > 12 mEq/L at 24 h and > 18 mEq/L at 48 h. Cases of ODS were rare and did not differ significantly between groups. Mortality, hospital length of stay, total hypertonic saline volume infused, and worsening hyponatremia also did not differ significantly between groups.
conclusionsIn adults with moderate-to-severe hyponatremia receiving standard therapy, proactive desmopressin was associated with a lower risk of overcorrection. This reduction was not accompanied by clear differences in ODS, worsening hyponatremia, or mortality. Further prospective randomized studies are needed to better define the optimal timing, dosing, and patient selection for this strategy. PROSPERO: CRD420251043907 CLINICAL TRIAL NUMBER: Not applicable.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.