Understanding Sodium: Edelman’s Insights and Framework for the Management of Dysnatremias: A Narrative Review of Literature

Clinicians have long faced challenges and decisions regarding sodium management in their patients. They must have a good understanding of the physiology of sodium, its metabolism, distribution in the body, and the consequences of changes in sodium content and concentration seen frequently in different settings of patient care and across different specialties. Multiple studies and several formulas are currently available to help manage cases with dysnatremia. These tools require a detailed focus to benefit patients in the short and long term and to avoid consequences due to poor decisions leading to severe and potentially fatal complications, including osmotic demyelination syndrome. This review will consider different aspects of sodium metabolism, the role sodium has in patients with edema, the evolution sodium management based on Edelman’s studies and related formulas, and other considerations regarding sodium storage in the skin currently relevant for a more in-depth approach to the management of patients with dysnatremias.