Hyponatremia

Rabia Kader KÖMÜRCÜ ÖZTÜRKa , Yasin Burak YILMAZa

aAnkara Bilkent City Hospital, Clinic of Emergency Medicine, Ankara, Türkiye

ABSTRACT
Hyponatremia is one of the most common electrolyte disorders. There can be wide range of symptoms from mild and non-specific complaints like dizziness to life-threatening conditions like brain edema. It is classified according to volume status, as hypervolemic, euvolemic and hypovolemic hyponatremia. Management of hyponatremia changes based on volume status.
Keywords: Hyponatremia; volume status; total body water; osmolality; electrolytes

Referanslar

  1. Adrogué HJ, Madias NE. Hyponatremia. N Engl J Med. 2000;342(21):1581-9. [Crossref]  [PubMed]
  2. Pfennig CL, Slovis CM. 114 - Electrolyte Disorders. Tenth Edit. (Walls RM, ed.). Elsevier Inc.; 2023.
  3. Lindner G, Schwarz C, Haidinger M, Ravioli S. Hyponatremia in the emergency department. Am J Emerg Med. 2022;60:1-8. [Crossref]  [PubMed]
  4. Olsson K, Öhlin B, Melander O. Epidemiology and characteristics of hyponatremia in the emergency department. Eur J Intern Med. 2013;24(2):110-6. [Crossref]  [PubMed]
  5. Boyer S, Gayot C, Bimou C, Mergans T, Kajeu P, Castelli M, et al. Prevalence of mild hyponatremia and its association with falls in older adults admitted to an emergency geriatric medicine unit (the MUPA unit). BMC Geriatr. 2019;19(1):265. [Crossref]  [PubMed]  [PMC]
  6. Arampatzis S, Funk GC, Leichtle AB, Fiedler GM, Schwarz C, Zimmermann H, et al. Impact of diuretic therapy-associated electrolyte disorders present on admission to the emergency department: a cross-sectional analysis. BMC Med. 2013;11:83. [Crossref]  [PubMed]  [PMC]
  7. Mannesse CK, Vondeling AM, van Marum RJ, van Solinge WW, Egberts TC, et al. Prevalence of hyponatremia on geriatric wards compared to other settings over four decades: a systematic review. Ageing Res Rev. 2013;12(1): 165-73. [Crossref]  [PubMed]
  8. Filippatos TD, Makri A, Elisaf MS, Liamis G. Hyponatremia in the elderly: challenges and solutions. Clin Interv Aging. 2017;12:1957-65. [Crossref]  [PubMed]  [PMC]
  9. Woitok BK, Funk GC, Walter P, Schwarz C, Ravioli S, Lindner G. Dysnatremias in emergency patients with acute kidney injury: A cross-sectional analysis. Am J Emerg Med. 2020;38(12):2602-6. [Crossref]  [PubMed]
  10. Hillier TA, Abbott RD, Barrett EJ. Hyponatremia: evaluating the correction factor for hyperglycemia. Am J Med. 1999;106(4):399-403. [Crossref]  [PubMed]
  11. Edelman IS, Leibman J, O'meara MP, Birkenfeld LW. Interrelations between serum sodium concentration, serum osmolarity and total exchangeable sodium, total exchangeable potassium and total body water. J Clin Invest. 1958;37(9):1236-56. [Crossref]  [PubMed]  [PMC]
  12. Spasovski G, Vanholder R, Allolio B, Annane D, Ball S, Bichet D, et al. Hyponatraemia Guideline Development Group. Clinical practice guideline on diagnosis and treatment of hyponatraemia. Eur J Endocrinol. 2014;170(3): G1-47. Erratum in: Eur J Endocrinol. 2014;171(1): X1. [Crossref]  [PubMed]
  13. Baylis PH. Posterior pituitary function in health and disease. Clin Endocrinol Metab. 1983;12(3):747-70. [Crossref]  [PubMed]
  14. Sterns RH. Disorders of plasma sodium--causes, consequences, and correction. N Engl J Med. 2015;372(1):55-65. [Crossref]  [PubMed]
  15. Alukal JJ, John S, Thuluvath PJ. Hyponatremia in Cirrhosis: An Update. Am J Gastroenterol. 2020;115(11):1775-85. [Crossref]  [PubMed]
  16. Palmer BF, Alpern RJ. Pathogenesis of edema formation in the nephrotic syndrome. Kidney Int Suppl. 1997;59:S21-7.
  17. Rodenburg EM, Hoorn EJ, Ruiter R, Lous JJ, Hofman A, Uitterlinden AG, et al. Thiazide-associated hyponatremia: a population-based study. Am J Kidney Dis. 2013;62(1):67-72. [Crossref]  [PubMed]
  18. Petrino R, Marino R. Fluids and Electrolytes. In: Tintinalli JE, Ma OJ, Yealy DM, et al., eds. Tintinalli's Emergency Medicine: A Comprehensive Study Guide, 9th ed. McGraw-Hill Education; 2020. [Link]
  19. Wolf MB. Hyperglycemia-induced hyponatremia: Reevaluation of the Na+ correction factor. J Crit Care. 2017;42:54-58. [Crossref]  [PubMed]
  20. Ravioli S, Bahmad S, Funk GC, Schwarz C, Exadaktylos A, Lindner G. Risk of Electrolyte Disorders, Syncope, and Falls in Patients Taking Thiazide Diuretics: Results of a Cross-Sectional Study. Am J Med. 2021;134(9):1148-54. [Crossref]  [PubMed]
  21. Chifu I, Gerstl A, Lengenfelder B, Schmitt D, Nagler N, Fassnacht M, et al. Treatment of symptomatic hyponatremia with hypertonic saline: a real-life observational study. Eur J Endocrinol. 2021;184(5):647-55. [Crossref]  [PubMed]  [PMC]
  22. Ball S, Barth J, Levy M; Society for Endocrinology Clinical Committee. Society For Endocrinology Endocrine Emergency Guidance: Emergency management of severe symptomatic hyponatraemia in adult patients. Endocr Connect. 2016;5(5):G4-G6. [Crossref]  [PubMed]  [PMC]
  23. Verbalis JG, Goldsmith SR, Greenberg A, Korzelius C, Schrier RW, Sterns RH, et al. Diagnosis, evaluation, and treatment of hyponatremia: expert panel recommendations. Am J Med. 2013;126(10 Suppl 1):S1-42. [Crossref]  [PubMed]
  24. Ayus JC, Caputo D, Bazerque F, Heguilen R, Gonzalez CD, Moritz ML. Treatment of hyponatremic encephalopathy with a 3% sodium chloride protocol: a case series. Am J Kidney Dis. 2015;65(3):435-42. [Crossref]  [PubMed]
  25. Sterns RH, Hix JK, Silver S. Treating profound hyponatremia: a strategy for controlled correction. Am J kidney Dis. 2010;56(4):774-9. [Crossref]  [PubMed]
  26. Thomas DR, Cote TR, Lawhorne L, Levenson SA, Rubenstein LZ, Smith DA, et al. Dehydration Council. Understanding clinical dehydration and its treatment. J Am Med Dir Assoc. 2008;9(5):292-301. [Crossref]  [PubMed]
  27. Shah MK, Mandayam S, Adrogué HJ. Osmotic Demyelination Unrelated to Hyponatremia. Am J Kidney Dis. 2018;71(3):436-40. [Crossref]  [PubMed]
  28. Kalampokini S, Artemiadis A, Zis P, Hadjihannas L, Parpas G, Kyrri A, et al. Osmotic demyelination syndrome improving after immune-modulating treatment: Case report and literature review. Clin Neurol Neurosurg. 2021;208:106811. [Crossref]  [PubMed]
  29. Al-awqati Q. 108 - Disorders of Sodium and Water. Twenty Sev. Elsevier; 2022.
  30. Sterns RH. Diagnostic evaluation of adults with hyponatremia. Accessed Dec 26, 2023. [Link]