Key clinical recommendation	Strength of recommendation	References
Poor prognostic factors for severe hyponatremia in hospitalized patients include the presence of symptoms, sepsis, and respiratory failure.	B	12
The initial rate of sodium correction with hypertonic saline should not exceed 1 to 2 mmol per L per hour.	B	33
Overzealous correction of chronic hyponatremia can lead to central pontine myelinolysis.	B	9,10
Demeclocycline (Declomycin) in a dosage of 600 to 1,200 mg daily is effective in patients with refractory hyponatremia.	C	19,36
Loop diuretics can be used in patients with volume overload.	C	38
Arginine vasopressin receptor antagonists may be useful in patients with chronic hyponatremia.	C	40