Vol. 19 No. 2 (2021)
An Approach To:

An Approach to Hyponatremia

PDF HTML
  • Kaylie Schachter
Kaylie Schachter
Faculty of Medicine and Health Sciences, McGill University
salt
DOI: https://doi.org/10.26443/mjm.v19i1.833

Published 2021-07-12

Keywords

  • hyponatremia,
  • syndrome of inappropriate antidiuretic hormone (SIADH),
  • vaptans

How to Cite

1.
Schachter K. An Approach to Hyponatremia. McGill J Med [Internet]. 2021 Jul. 12 [cited 2025 Oct. 26];19(2). Available from: https://mjm.mcgill.ca/article/view/833

Copyright (c) 2021 McGill Journal of Medicine

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

Crossref
Scopus
Google Scholar
Europe PMC

Abstract

Hyponatremia is a common laboratory finding in numerous patients. It is defined as a serum sodium concentration <135 mmol/L and represents an excess of water in the extracellular compartment. The severity of this electrolyte abnormality ranges from asymptomatic to seizures, coma and death as a consequence of cerebral swelling. There are multiple medical conditions, medications and disease states that can cause hyponatremia. This article summarizes the important pathophysiological pathways involved in the development of hyponatremia, describes an approach to common causes and reviews the initial steps in management.

PDF HTML

Downloads

Download data is not yet available.

References

  1. Spasovski G, Vanholder R, Allolio B, Annane D, Ball S, Bichet D, et al. Clinical practice guideline on diagnosis and treatment of hyponatraemia. Intensive Care Med. 2014;40(3):320-31.
  2. Hoorn EJ, Zietse R. Diagnosis and Treatment of Hyponatremia: Compilation of the Guidelines. J Am Soc Nephrol. 2017;28(5):1340-9.
  3. Kasper DL, Fauci AS, Hauser SL, Longo DL, Jameson JL, Loscalzo J. Harrison's Principles of Internal Medicine. 19th ed: McGraw-Hill Education; 2015.
  4. Sterns RH. Disorders of plasma sodium--causes, consequences, and correction. N Engl J Med. 2015;372(1):55-65.
  5. JH Fountain SL. Physiology, renin angiotensin system. 2017.
  6. Yeates KE, Singer M, Morton AR. Salt and water: a simple approach to hyponatremia. Cmaj. 2004;170(3):365-9.
  7. Toronto Notes 2020: Comprehensive Medical Reference and Review for the Medical Council of Canada Qualifying Exam (MCCQE) Part I and the United States Medical Licensing Exam (USMLE) Step II 36th ed: Toronto Notes for Medical Students, Incorporated; 2020.
  8. Mathew A KF, Franek E, Drabczyk R. Hyponatremia. McMaster Textbook of Internal Medicine. Kraków: Medycyna Praktyczna; 2019.
  9. Seay NW, Lehrich RW, Greenberg A. Diagnosis and Management of Disorders of Body Tonicity-Hyponatremia and Hypernatremia: Core Curriculum 2020. Am J Kidney Dis. 2020;75(2):272-86.
  10. Theis SR, Khandhar PB. Pseudohyponatremia. StatPearls. Treasure Island (FL): StatPearls Publishing LLC.; 2021.
  11. Braun MM, Barstow CH, Pyzocha NJ. Diagnosis and management of sodium disorders: hyponatremia and hypernatremia. Am Fam Physician. 2015;91(5):299-307.
  12. Sabatine MS. Pocket Medicine: The Massachusetts General Hospital Handbook of Internal Medicine: Wolters Kluwer Law & Business; 2016.