ODS and K

Q: Which of the following is the bigger risk factor in the development of osmotic demyelination syndrome (ODS), due to rapid reversal of chronic hyponatremia? (select one)

A) Concurrent hyperkalemia

B) Concurrent hypokalemia

Answer: B

Osmotic demyelination syndrome (ODS) is the most dreaded outcome if sodium is too aggressively and quickly treated in chronic hyponatremia. A few of the risk factors for the development of ODS are:

• sodium ≤105 mEq/L
• Concurrent hypokalemia
• History of alcohol abuse
• Acute or chronic hepatic disease
• Malnourishment
• Hypophosphatemia

#neurology

#electrolyte

References:

1. Ambati R, Kho LK, Prentice D, Thompson A. Osmotic demyelination syndrome: novel risk factors and proposed pathophysiology. Intern Med J. 2023 Jul;53(7):1154-1162. doi: 10.1111/imj.15855. Epub 2022 Sep 16. PMID: 35717664.

2. Reijnders TDY, Janssen WMT, Niamut SML, Kramer AB. Role of Risk Factors in Developing Osmotic Demyelination Syndrome During Correction of Hyponatremia: A Case Study. Cureus. 2020 Jan 2;12(1):e6547. doi: 10.7759/cureus.6547. PMID: 32042522; PMCID: PMC6996461.