Medicina Fluminensis, Vol. 50. No. 4, 2014.
Review article
Hyponatraemia – diagnostic and therapeutic approach
Tamara Turk Wensveen
; Zavod za endokrinologiju, dijabetes i bolesti metabolizma, Klinika za internu medicinu, KBC Rijeka, Rijeka
Irena Krznarić Zrnić
; Zavod za gastroenterologiju, Klinika za internu medicinu, KBC Rijeka, Rijeka
Goran Hauser
; Zavod za gastroenterologiju, Klinika za internu medicinu, KBC Rijeka, Rijeka
Željka Crnčević Orlić
; Zavod za endokrinologiju, dijabetes i bolesti metabolizma, Klinika za internu medicinu, KBC Rijeka, Rijeka
Abstract
Hyponatraemia is the most frequent disorder of body fluid and electrolyte balance in clinical practice. It is present in 15–30 % of hospitalized patients and can be manifested with a wide spectrum of clinical symptoms, ranging from very subtle to life threatening. Hyponatraemia is primarily a disbalance in water equilibrium, usually manifested as relative water overload in comparison to total body sodium and potassium concentration. Based on the time of development hyponatraemia can be defined as acute (< 48hrs) or chronic (≥48 hrs). Regarding serum sodium concentration, hyponatraemia can be mild (Na(s) 130–135 mmol/l), moderate (Na(s) 125–129 mmol/l) or profound (Na(s) < 125 mmol/l). When approaching a patient with hyponatraemia it is essential to determine whether hyponatraemia is acute or profound so we could immediately start giving a patient 3 % hypertonic saline. In absence of the above mentioned, the diagnostic algorithm, with emphasis on urine osmolality and urine sodium concentration, is guiding us towards more specific disorders which define proper therapeutic approach.
Keywords
electrolytes; sodium; water-electrolyte imbalance
Hrčak ID:
129783
URI
Publication date:
1.12.2014.
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