The treatment of hyponatremia should be guided by the clinical setting. Patients with chronic hyponatremia require no specific therapy other than restricting water intake. Rapid sodium correction in patients with chronic asymptomatic hyponatremia may be hazardous.
If fluid must be given to patients with SIADH, then the osmolality of the administered fluid must exceed the osmolality of the urine. Otherwise, the hyponatremia may worsen. Because of the high associated mortality, acute symptomatic hyponatremia represents a medical emergency. Isotonic saline should be administered to patients with true volume depletion, diuretic therapy, or adrenal insufficiency, in which cortisol replacement is also indicated.
Although sodium concentrations should generally not be increased faster than 1. Metabolic disorders. Managing epilepsy and co-existing disorders. Boston: Butterworth-Heinemann; ;— With permission from Elsevier www. Fluids and Electrolytes. Philadelphia: Saunders, ;— The mission of the Epilepsy Foundation is to lead the fight to overcome the challenges of living with epilepsy and to accelerate therapies to stop seizures, find cures, and save lives.
Skip to main content. Causes Hyponatremia is relatively common in hospitalized patients. The syndrome of inappropriate secretion of antidiuretic hormone SIADH has many possible causes: 8,9 Malignant neoplasia Carcinoma: bronchogenic, pancreatic, duodenal, ureteral, prostatic, bladder Lymphoma and leukemia Thymoma and mesothelioma Central nervous system disorders Trauma Infection Tumors Porphyria Pulmonary disorders Tuberculosis Pneumonia Fungal infections Lung abscesses Ventilators with positive pressure Drugs Desmopressin Oxytocin Vincristine Chlorpropamide Nicotine Cyclophosphamide Morphine Amitriptyline Selective serotonin reuptake inhibitors SSRIs Hyponatremia may also be seen in cerebral or renal salt-wasting conditions.
Clinical presentation Because acute hyponatremia causes plasma osmolality to fall, water moves into cells to maintain osmotic equilibrium between the extracellular and intracellular fluid. It helps maintain normal blood pressure, supports the work of your nerves and muscles, and regulates your body's fluid balance.
In chronic hyponatremia, sodium levels drop gradually over 48 hours or longer — and symptoms and complications are typically more moderate. In acute hyponatremia, sodium levels drop rapidly — resulting in potentially dangerous effects, such as rapid brain swelling, which can result in a coma and death.
Premenopausal women appear to be at the greatest risk of hyponatremia-related brain damage. This may be related to the effect of women's sex hormones on the body's ability to balance sodium levels.
Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission. This content does not have an English version. This content does not have an Arabic version. Overview Hyponatremia occurs when the concentration of sodium in your blood is abnormally low. Request an Appointment at Mayo Clinic. Share on: Facebook Twitter. Show references Jameson JL, et al. Hyponatremia and hypernatremia. In: Endocrinology: Adult and Pediatric. Philadelphia, Pa.
Accessed April 6, Bope ET, et al. In: Conn's Current Therapy Merck Manual Professional Version. Kengne FG, et al.
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