Limits for safe correction are difficult to define when the serum sodium concentration is extremely low. Limits for safe correction are difficult to define.

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Limits for safe correction are difficult to define when the serum sodium concentration is extremely low. Limits for safe correction are difficult to define when the serum sodium concentration is extremely low. This patient presented with mild symptoms despite a serum sodium of 100 mEq/L. Beginning on the third day after correction by 8 mEq/L per day, the patient developed new progressive symptoms, including dysphasia, psychosis, and dyskinetic movements consistent with a diagnosis of osmotic demyelination syndrome. However, the symptoms resolved spontaneously, and magnetic resonance imaging was negative. D, day; GCS, Glascow coma scale. Reprinted from ref. 42, with permission. Richard H. Sterns CJASN 2018;13:641-649 ©2018 by American Society of Nephrology