Myelinolysis is more likely to occur if certain risk factors are present. Awareness of the risk factors can help prevent occurrence of this serious neurologic disorder.
Risk factors:
(1) hyponatremia for > 48 hours
(2) saline infusions causing an increase in serum sodium > 8 mmol/L per day in a patient with chronic hyponatremia
(3) presence of chronic liver disease in a patient with hyponatremia
(4) history of orthotopic liver transplantation in a patient with hyponatremia
where:
• I am not sure if the risk for patients following orthotopic liver transplants is independent of the hyponatremia.
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