Efficacy and Safety of Rapid Intermittent Compared With Slow Continuous Correction in Severe Hyponatremia Patients

Inclusion Criteria: * In emergency setting (2016.6-) and/or inpatients at ward (2018.9-) * Glucose corrected serum sodium ≤125 mmol/L * Patients with moderately severe or severe symptom * Moderately severe :Nausea without vomiting Drowsy, Headache General weakness, myalgia * Severe :Vomiting, Stupor, Seizures, Coma (Glasgow Coma Scale ≤8) * written consent Exclusion Criteria: * Pseudohyponatremia: serum osmolality \> 275 mOsm/kg \- If the serum osmolality is \> 275 mOsm/kg but the BUN is ≥ 30 mg/dL, the patients can be registered if calculated serum osmolality (2 x plasma \[Na\] + \[Glucose\]/18) is \<275 mOsm/kg * Primary polydipsia: urine osmolality ≤ 100 mOsm/kg * Glucose corrected serum sodium \>125 mmol/L * Arterial hypotension (SBP \<90mmHg and MAP \<70mmHg) * Anuria or urinary outlet obstruction * Liver disease * transaminase levels \>3 times the upper limit normal * Known LC with ascites or diuretics use or PSE Hx or Varix Hx * Uncontrolled diabetes mellitus (HbA1C \> 9%) * Women who are pregnant or breast feeding * History of cardiac surgery excluding PCA, acute myocardial infarction, sustained ventricular tachycardia, ventricular fibrillation, acute coronary syndrome, cebrovascular trauma, and increased intracranial pressure within the 3 months prior to randomization