Despite these changes not being statistically significant, there was a highly significant decrease in the bone resorption index, calculated as change from baseline in urine NTx:creatinine ratio divided by change in serum osteocalcin. 37 This improvement in bone resorption index is particularly striking, considering that it was observed after only 22 days of tolvaptan-induced hyponatremia correction. 37 The second study was a randomized trial of patients with epilepsy and chronic hyponatremia, assessing the impact of 3-month salt replacement therapy on BTMs and BMD. 40 At baseline, neither BMD nor BTMs were abnormal.
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Association of hyponatremia with bone mineral density and fractures: a narrative review.
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