31 March 2026

Targeted correction of hyponatraemia during hospitalization does not improve clinical outcome

The largest randomised trial to date on the treatment of chronic hyponatraemia in hospitalised patients shows that despite successful normalisation of sodium levels, mortality or the frequency of re-hospitalisations cannot be reduced.

Hyponatraemia is the most common electrolyte disturbance in hospitalised patients and is associated with falls, neurocognitive impairments, and increased mortality. Whether these are causally related to the hyponatraemia itself or to underlying diseases is unclear. The results of the HIT study (Hyponatraemia Intervention Trial), conducted under the direction of Prof. Mirjam Christ-Crain and published in the journal NEJM Evidence, provide the first evidence from a large randomised setting.

Better correction of hyponatremia

The study indicates that a structured diagnosis and treatment algorithm can achieve higher rates of normal sodium levels compared to standard treatment (60.4% in the intervention group and 46.2% in the control group).

No advantage in the clinical endpoint

Mortality and rehospitalisation were measured as the cumulative primary endpoint after 30 days. These events occurred with approximately the same frequency in both groups (20.5% in the intervention group and 21.8% in the control group) with no significant difference. Thus, no correlation between normalised sodium levels and clinical outcomes could be established.