Keywords
Hyponatremia
Electrolytes
Sodium
Saline solu
Body Water
Electrolytes
Sodium
Saline solu
Body Water
How to Cite
Mejía-Sandoval, H. J., Castellanos-Bueno, R., Rangel-Rivera, D. A., & Rangel-Rivera, K. L. (2020). Practical aspects for the classification and management of hyponatremia in the hospitalized patient. Médicas UIS, 33(2), 85–93. https://doi.org/10.18273/revmed.v33n2-2020009
Abstract
Hyponatremia is the most frequent hydroelectrolytic disorder observed in hospitalized patients and it is important to note that it has
been associated with morbidity and mortality in this patients. This entity represents a pathophysiological process related to an alteration
in water homeostasis, in which patients present symptoms mostly neurological, that correlate with the sodium level and the time of
onset of the disorder. A search of the PubMed and Lilacs databases of monographies, review articles and originals articles was performed
with the objective to review clinical, diagnostic and management aspects of this entity. For diagnosis, the clinical laboratory studies are
requested depending on the clinical context, acting early and allowing correction of the disorder according to the respective scenario.
Hyponatremia is a frequent medical problem that requires a practical and simple approach favoring clinical decisions in a timely manner.
MÉD.UIS. 2020;33(2):85-93.
References
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Waikar SS, Mount DB, Curhan GC. Mortality after Hospitalization with Mild, Moderate, and Severe Hyponatremia. Am J Med. 2009;122(9):857–65.
Liamis G, Rodenburg EM, Hofman A, Zietse R, Stricker BH, Hoorn EJ. Electrolyte Disorders in Community Subjects: Prevalence and Risk Factors. Am J Med. 013;126(3):256–63.
Mannesse CK, Vondeling AM, van Marum RJ, van Solinge WW, Egberts TCG, Jansen PAF. Prevalence of hyponatremia on geriatric wards compared to other settings over four decades: A systematic review. Ageing Res Rev. 2013;12(1):165–73.
Burguera V, Rodríguez-Palomares JR, Fernández-Codejón O, Tenorio MT, Rey JM del, Liaño F. Epidemiología de la hiponatremia. Nefrología. 2011;2(2):1–83.
Ganguli A, Mascarenhas RC, Jamshed N, Tefera E, Veis JH.Hyponatremia: incidence, risk factors, and consequences in the elderly in a home-based primary care program. Clin Nephrol. 2015;84(8):75–85.
EJ, Zietse R. Diagnosis and Treatment of Hyponatremia: Compilation of the Guidelines. J Am Soc Nephrol. 2017;28(5):1340–9.
Godoy DA, Álvare E, Campi V, Soler C, Masotti L, Di Napoli M. Enfoque práctico para el diagnóstico y tratamiento de los estados poliúricos en pacientes con injuria erebral aguda. Rev Med Chil. 2013;141(5):616–25.
Adrogué HJ, Madias NE. The Challenge of Hyponatremia. J Am Soc Nephrol. 2012;23(7):1140–8.
Zieg J. Pathophysiology of Hyponatremia in Children. Front Pediatr. 2017;5(x).
Braun MM, Barstow CH, Pyzocha NJ. Diagnosis and management of sodium disorders: hyponatremia and hypernatremia. Am Fam Physician. 2015;91(5):299–307.
Jeppesen AN, Jensen HK, Donskov F, Marcussen N, von der Maase H. Hyponatremia as a prognostic and predictive factor in metastatic renal cell carcinoma. Br J Cancer. 2010;102(5):867–72.
Tzoulis P, Bagkeris E, Bouloux P-M. A case-control study of hyponatraemia as an independent risk factor for inpatient mortality. Clin. Endocrinol (Oxf). 2014;81(3):401–7.
Holland-Bill L, Christiansen CF, Heide-Jørgensen U, Ulrichsen SP, Ring T, Jørgensen JOL, et al. Hyponatremia and mortality risk: a Danish cohort study of 279508 acutely hospitalized patients. Eur. J. Endocrinol. 2015;173(1):71–81. }
Hoorn EJ, Spasovski G. Recent developments in the management of acute and chronic hyponatremia. Curr Opin Nephrol Hypertens. 2019;28(5):424–32.
Verbalis JG. Disorders of water balance. EN: Duffy NA, coordinador.. Brenner and Rector’s The Kidney. 11a ed. Canadá: Elsevier; 2019. p. 443-95.
Gunathilake R, Oldmeadow C, McEvoy M, Kelly B, Inder K, Schofield P, et al. Mild hyponatremia is associated with impaired cognition and falls in community-dwelling older persons. J Am Geriatr Soc. 2013;61(10):1838–9.
Chung MC, Yu TM, Shu KH, Wu MJ, Chang CH, Muo CH, et al. Hyponatremia and increased risk of dementia: A population-based retrospective cohort study. PLoS One. 2017;12(6):1–11.
Shavit L, Mikeladze I, Torem C, Slotki I. Mild hyponatremia is associated with functional and cognitive decline in chronic hemodialysis patients. Clin Nephrol. 2014;82(5):313-9.
Henry DA. In the clinic: Hyponatremia. Ann Intern Med. 2015;163(3):ITC1-ITC19.
Buffington MA, Abreo K. Hyponatremia: A Review. J Intensive Care Med. 2016;31(4):223–36.
Adrogué HJ, Madias NE. Hyponatremia. N Engl J Med. 2000;342(21):1581–9.
Spasovski G, Vanholder R, Allolio B, Annane D, Ball S, Bichet D, et al. Clinical practice guideline on diagnosis and treatment of hyponatraemia. Eur. J. Endocrinol. 2014;170(3):1–47.
Pedrós C, Arnau JM. Hiponatremia y SIADH por medicamentos. Rev Esp Geriatr Gerontol. 2010;45(4):229–31.
Hoorn EJ, Zietse R. Diagnosis and treatment of hyponatremia: Compilation of the guidelines. J Am Soc Nephrol. 2017;28(5):1340–9.
Musch W, Thimpont J, Vandervelde D, Verhaeverbeke I, Berghmans T, Decaux G. Combined fractional excretion of sodium and urea better predicts response to saline in hyponatremia than do usual clinical and biochemical parameters. Am J Med. 1995;99(4):348– 55.
Chung H-M, Kluge R, Schrier RW, Anderson RJ. Clinical assessment of extracellular fluid volume in hyponatremia. Am J Med. 1987;83(5):905–8. Sterns RH. Disorders of Plasma Sodium - Causes, Consequences, and Correction. N Engl J Med. 2015;372(1):55–65.
Sterns RH. Disorders of Plasma Sodium — Causes, Consequences, and Correction. N Engl J Med. 2015;372(1):55–65.
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):1-42.
Sterns RH. Treatment of Severe Hyponatremia. Clin J Am Soc Nephrol. 2018;13(4):641–9.
Lambeck J, Hieber M, Dreßing A, Niesen W-D. Central pontine myelinolysis and osmotic demyelination syndrome. Dtsch Aerztbl Int. 2019;116:600-6.
Ball SG, Iqbal Z. Diagnosis and treatment of hyponatraemia. BestPract Res Clin Endocrinol Metab. 2016;30(2):161–73.
Rondon-Berrios H, Agaba EI, Tzamaloukas AH. Hyponatremia: pathophysiology, classification, manifestations and management. Int Urol Nephrol. 2014;46(11):2153–65.
Waikar SS, Mount DB, Curhan GC. Mortality after Hospitalization with Mild, Moderate, and Severe Hyponatremia. Am J Med. 2009;122(9):857–65.
Liamis G, Rodenburg EM, Hofman A, Zietse R, Stricker BH, Hoorn EJ. Electrolyte Disorders in Community Subjects: Prevalence and Risk Factors. Am J Med. 013;126(3):256–63.
Mannesse CK, Vondeling AM, van Marum RJ, van Solinge WW, Egberts TCG, Jansen PAF. Prevalence of hyponatremia on geriatric wards compared to other settings over four decades: A systematic review. Ageing Res Rev. 2013;12(1):165–73.
Burguera V, Rodríguez-Palomares JR, Fernández-Codejón O, Tenorio MT, Rey JM del, Liaño F. Epidemiología de la hiponatremia. Nefrología. 2011;2(2):1–83.
Ganguli A, Mascarenhas RC, Jamshed N, Tefera E, Veis JH.Hyponatremia: incidence, risk factors, and consequences in the elderly in a home-based primary care program. Clin Nephrol. 2015;84(8):75–85.
EJ, Zietse R. Diagnosis and Treatment of Hyponatremia: Compilation of the Guidelines. J Am Soc Nephrol. 2017;28(5):1340–9.
Godoy DA, Álvare E, Campi V, Soler C, Masotti L, Di Napoli M. Enfoque práctico para el diagnóstico y tratamiento de los estados poliúricos en pacientes con injuria erebral aguda. Rev Med Chil. 2013;141(5):616–25.
Adrogué HJ, Madias NE. The Challenge of Hyponatremia. J Am Soc Nephrol. 2012;23(7):1140–8.
Zieg J. Pathophysiology of Hyponatremia in Children. Front Pediatr. 2017;5(x).
Braun MM, Barstow CH, Pyzocha NJ. Diagnosis and management of sodium disorders: hyponatremia and hypernatremia. Am Fam Physician. 2015;91(5):299–307.
Jeppesen AN, Jensen HK, Donskov F, Marcussen N, von der Maase H. Hyponatremia as a prognostic and predictive factor in metastatic renal cell carcinoma. Br J Cancer. 2010;102(5):867–72.
Tzoulis P, Bagkeris E, Bouloux P-M. A case-control study of hyponatraemia as an independent risk factor for inpatient mortality. Clin. Endocrinol (Oxf). 2014;81(3):401–7.
Holland-Bill L, Christiansen CF, Heide-Jørgensen U, Ulrichsen SP, Ring T, Jørgensen JOL, et al. Hyponatremia and mortality risk: a Danish cohort study of 279508 acutely hospitalized patients. Eur. J. Endocrinol. 2015;173(1):71–81. }
Hoorn EJ, Spasovski G. Recent developments in the management of acute and chronic hyponatremia. Curr Opin Nephrol Hypertens. 2019;28(5):424–32.
Verbalis JG. Disorders of water balance. EN: Duffy NA, coordinador.. Brenner and Rector’s The Kidney. 11a ed. Canadá: Elsevier; 2019. p. 443-95.
Gunathilake R, Oldmeadow C, McEvoy M, Kelly B, Inder K, Schofield P, et al. Mild hyponatremia is associated with impaired cognition and falls in community-dwelling older persons. J Am Geriatr Soc. 2013;61(10):1838–9.
Chung MC, Yu TM, Shu KH, Wu MJ, Chang CH, Muo CH, et al. Hyponatremia and increased risk of dementia: A population-based retrospective cohort study. PLoS One. 2017;12(6):1–11.
Shavit L, Mikeladze I, Torem C, Slotki I. Mild hyponatremia is associated with functional and cognitive decline in chronic hemodialysis patients. Clin Nephrol. 2014;82(5):313-9.
Henry DA. In the clinic: Hyponatremia. Ann Intern Med. 2015;163(3):ITC1-ITC19.
Buffington MA, Abreo K. Hyponatremia: A Review. J Intensive Care Med. 2016;31(4):223–36.
Adrogué HJ, Madias NE. Hyponatremia. N Engl J Med. 2000;342(21):1581–9.
Spasovski G, Vanholder R, Allolio B, Annane D, Ball S, Bichet D, et al. Clinical practice guideline on diagnosis and treatment of hyponatraemia. Eur. J. Endocrinol. 2014;170(3):1–47.
Pedrós C, Arnau JM. Hiponatremia y SIADH por medicamentos. Rev Esp Geriatr Gerontol. 2010;45(4):229–31.
Hoorn EJ, Zietse R. Diagnosis and treatment of hyponatremia: Compilation of the guidelines. J Am Soc Nephrol. 2017;28(5):1340–9.
Musch W, Thimpont J, Vandervelde D, Verhaeverbeke I, Berghmans T, Decaux G. Combined fractional excretion of sodium and urea better predicts response to saline in hyponatremia than do usual clinical and biochemical parameters. Am J Med. 1995;99(4):348– 55.
Chung H-M, Kluge R, Schrier RW, Anderson RJ. Clinical assessment of extracellular fluid volume in hyponatremia. Am J Med. 1987;83(5):905–8. Sterns RH. Disorders of Plasma Sodium - Causes, Consequences, and Correction. N Engl J Med. 2015;372(1):55–65.
Sterns RH. Disorders of Plasma Sodium — Causes, Consequences, and Correction. N Engl J Med. 2015;372(1):55–65.
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):1-42.
Sterns RH. Treatment of Severe Hyponatremia. Clin J Am Soc Nephrol. 2018;13(4):641–9.
Lambeck J, Hieber M, Dreßing A, Niesen W-D. Central pontine myelinolysis and osmotic demyelination syndrome. Dtsch Aerztbl Int. 2019;116:600-6.
Ball SG, Iqbal Z. Diagnosis and treatment of hyponatraemia. BestPract Res Clin Endocrinol Metab. 2016;30(2):161–73.
Rondon-Berrios H, Agaba EI, Tzamaloukas AH. Hyponatremia: pathophysiology, classification, manifestations and management. Int Urol Nephrol. 2014;46(11):2153–65.
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