The following article is part of conference coverage from the NKF 2018 Spring Clinical Meetings in Austin hosted by the National Kidney Foundation. Renal & Urology News staff will be reporting on medical studies conducted by nephrologists and other specialists who are tops in their field in chronic kidney disease, dialysis, transplantation, and more. Check back for the latest news from NKF 2018.

AUSTIN, Texas—Treatment of inpatient hyponatremia with a novel American formulation of urea is safe and effective, according to study findings presented at the National Kidney Foundation’s 2018 Spring Clinical Meetings.

The study, by Helbert Rondon-Berrios, MD, Associate Professor of Medicine in the Renal-Electrolyte Division at the University of Pittsburgh School of Medicine, and colleagues, included 58 hospitalized patients with hyponatremia (plasma sodium level below 135 mEq/L) and treated with a new formulation of urea among other therapies. The median age of these patients was 67.5 years, and 35 patients (60%) were male. Patient received urea at a dosage of 7.5 to 90 g/day for a median duration of 4.5 days.

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Among patients in this cohort, the investigators found 14 patients who received urea as the sole drug therapy for hyponatremia (cases) and matched them 1:1 to 14 hyponatremic patients hospitalized in the prior year and who did not receive urea treatment (controls). The investigators matched cases and controls by sex, etiology, and degree of hyponatremia.

Urea therapy was associated with a significant increase in median plasma sodium level from 124 to 130.5 mEq/L in the entire cohort and from a median of 125 to 132 mEq/L in cases, Dr Rondon-Berrios’ group reported. A significantly greater proportion of cases achieved a normal plasma sodium level than controls (43% vs 7%). The investigators observed no significant difference in the change in plasma sodium levels at the end of therapy or in length of hospital stay in cases compared with controls.

In the entire cohort of patients who received urea, the researchers observed no episodes of overcorrection of plasma sodium and no adverse events associated with the use of urea. They noted that 1 patient discontinued urea as a result of poor palatability.

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He and his colleagues noted that the study was limited by retrospective design, small sample size and relatively short duration of urea therapy.

“The significance of this study relates to the finding that a novel formulation of urea now available for use in the United States appears to be effective and safe for the management of inpatient hyponatremia and is well tolerated by patients,” Dr Rondon-Berrios told Renal & Urology News.

See more coverage from the National Kidney Foundation Spring Clinical meeting


Rondon-Berrios H, Tandukar S, Mor MK, Weisbord SD. Urea in the treatment of hyponatremia: The first reported US inpatient experience. Data presented at the National Kidney Foundation’s 2018 Spring Clinical Meetings, held from April 10–14. Poster 261.