New Study: American Formulation of Oral Urea Effective Treatment for Abnormally Low Blood Sodium Levels

AUSTIN, TX—April 11, 2018—The first study to review the use of an American formulation of urea for hospitalized patients with abnormally low blood sodium levels shows it to be an effective, safe and inexpensive treatment, according to findings presented at the National Kidney Foundation 2018 Spring Clinical Meetings in Austin, Texas.
Abnormally low blood sodium, a condition known as hyponatremia, can cause a range of symptoms including headaches, confusion and nausea. In severe cases, hyponatremia is life-threatening. It is important to raise and lower levels of serum sodium carefully as rapid rise can lead to severe symptoms as well.
Many common treatments for hyponatremia in the United States have not been well-studied, and some, such as the administration of vasopressin antagonists, are expensive and pose risks, said the researchers, who are based at the University of Pittsburgh. Urea is rarely used to treat hyponatremia in the United States, despite its popularity as a remedy for the condition in Europe and the results of small studies conducted there indicating it is both safe and effective against hyponatremia.
“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,” said study lead author Helbert Rondon-Berrios, associate professor of medicine in the Renal-Electrolyte Division at the University of Pittsburgh School of Medicine and associate director of its Nephrology Fellowship Training Program.
The study tracked the levels of plasma sodium for 58 hospitalized patients diagnosed with hyponatremia both before and after each was treated with a new American formulation of urea as well as other therapies. The authors also identified 14 patients who received urea as the sole drug therapy for hyponatremia.
Study group patients were paired with a control group with similar demographic profiles who did not receive urea but received other drug therapies for hyponatremia such as vasopressin antagonists, salt tablets, and loop diuretics, and whose plasma sodium levels researchers also tracked. Plasma sodium level normalized in 43 percent of patients who received urea as the sole therapy for hyponatremia, while normalization occurred in only 7 percent of patients in the control group (P=0.03). One study group patient dropped out due to an aversion to the taste of urea, which is often described as bitter.
Urea therapy was associated in the entire study group with a plasma sodium increase from 124 mEq/L to 130.5 mEq/L(P<0.001). Among the patients who received only urea, the plasma sodium increased from 125 mEq/L to 132 mEq/L (P<0.001). No ill effects from the treatment were reported.
Over 80 percent of the study group (47 patients) had the Syndrome of Inappropriate Antidiuretic Hormone (SIADH), which occurs when a hormone that helps the kidney regulate water is produced in excess, causing the body to retain water and causing sodium levels to drop.
NKF Spring Clinical Meetings
For the past 27 years, nephrology healthcare professionals from across the country have come to NKF’s Spring Clinical Meetings to learn about the newest developments related to all aspects of nephrology practice; network with colleagues; and present their research findings. The NKF Spring Clinical Meetings are designed for meaningful change in the multidisciplinary healthcare teams’ skills, performance, and patient health outcomes. It is the only conference of its kind that focuses on translating science into practice for the entire healthcare team. 
Kidney Disease Facts
30 million American adults are estimated to have chronic kidney disease—and most aren’t aware of it. 1 in 3 American adults are at risk for chronic kidney disease. Risk factors for kidney disease include diabetes, high blood pressure, heart disease, obesity and family history of kidney failure. People of African American, Hispanic, Native American, Asian or Pacific Islander descent are at increased risk for developing the disease. African Americans are 3 times more likely than Whites, and Hispanics are nearly 1.5 times more likely than non-Hispanics to develop end-stage renal disease (kidney failure).
The National Kidney Foundation (NKF) is the largest, most comprehensive and longstanding organization dedicated to the awareness, prevention and treatment of kidney disease. For more information about NKF visit