Hyponatremia: Description:Abnormally low concentrations of sodium ions in the circulating blood.ICD-9: 276.1.HyponatremiaSodium is found mostly in body fluids outside the cells. It is very important for maintaining blood pressure. Sodium is also needed for nerves and muscles to work properly. A very low concentration of sodium in one's blood serum characterizes hyponatremia. When someone consumes too much water or his body can't get rid of fluids effectively, it can occur.Types: Euvolemic, dilutional, hypervolemic, and hypovolemic.Symptoms:Common symptoms include:1. Dizziness.2. Weakness.3. Nausea and vomiting.4. Slurred speech.5. Confusion.6. Muscle cramps.7. Loss of consciousness.8. Seizures in severe cases.Other Symptoms Include:Symptoms of moderate it include tiredness, disorientation, headache, muscle cramps, and nausea. Severe hyponatremia can lead to seizures and coma. These neurological symptoms are thought to result from the movement of water into brain cells, causing them to swell and disrupt their functioning.Causes and Risk Factors:Hyponatremia can be caused by the following:
  • It is more likely to occur in people whose kidneys do not function properly, as well as in those with heart failure, cirrhosis of the liver, and Addison's disease, in which under active adrenal glands excrete too much sodium.
  • Diuretic drugs used to treat high blood pressure. These drugs make the kidneys produce more urine, which can wash away too much sodium, especially when the patient is following a low sodium diet. This is especially of concern in elderly patients, who have a reduced ability to regulate the concentrations of various nutrients in the bloodstream. Diuretic drugs that frequently cause it include furosemide (Lasix), bumetanide (Bumex), and most commonly, the thiazides. Diuretics enhance the excretion of sodium into the urine, with the goal of correcting high blood pressure. However, too much sodium excretion can result in it. Usually only mild hyponatremia occurs in patients taking diuretics, but when combined with low sodium diet or with the excessive drinking of water, severe it can develop.
  • Some psychiatric disorders cause people to drink extremely large quantities of water, which can result in hyponatremia.
  • Drinking excess water sometimes causes hyponatremia, because the absorption of water into the bloodstream can dilute the sodium in the blood. This cause of hyponatremia is rare, but has been found in psychotic patients who compulsively drink more than 20 liters of water per day.
  • Receiving too much fluid intravenously.
  • Excessive drinking of beer, which is mainly water and low in sodium, can also produce hyponatremia when combined with a poor diet.
  • Maintenance of a low salt diet for many months.
  • Severe and prolonged diarrhea and prolonged vomiting sometimes causes hyponatremia.
  • Excessive sweat loss during a race on a hot day can present a challenge to the body to conserve adequate sodium levels. Marathon running, under certain conditions, leads to hyponatremia. Races of 25-50 miles can result in the loss of great quantities (8 to 10 liters) of sweat, which contains both sodium and water. Studies show that about 30% of marathon runners experience mild is during a race. But runners who consume only pure water during a race can develop severe hyponatremia because the drinking water dilutes the sodium in the bloodstream. Such runners may experience neurological disorders as a result of the severe it and require emergency treatment.
  • Hypothalamus and pituitary disorders.
Diagnosis:The health care provider will perform a complete physical examination to help determine the cause of your symptoms. Blood and urine tests will be done.Three laboratory findings may provide important information in the differential diagnosis of hyponatremia: the plasma osmolality, the urine osmolality, and the urine sodium concentration.A serum osmolality test is particularly helpful in diagnosing true hyposmolar hyponatremia. Serum osmolality findings are abnormally low if a person has hyposmolar hyponatremia. Normal findings are noted with a patient that has pseudohyponatremia that is due to hyperlipidemia or hyperproteinemia.Urine osmolality tests are also used for hyponatremia diagnosis as well as establishing SIADH. Those with SIADH will have urine osmolarities higher than 100 mOsm/L. Patients that have hyponatremia but with appropriately low levels of ADH will have urine osmolarities of below 100 mOsm/LNote: If you are taking in any medications, it is important that you inform your physician immediately. Some medications are needed to be discontinued temporarily before the test as they can interfere with the lab results, and may cause problems in hyponatremia diagnosis.The symptoms of sudden it often suggest other conditions, and misdiagnose puts you at risk. A rapid shift in electrolyte levels can cause immediate brain swelling and severe complications. It is best to identify hyponatremia early and treat the condition to gradually diminish or eliminate its effects.Treatment:If you have moderate, chronic is due to your diet, diuretics or excessive water consumption, your doctor may recommend temporarily cutting back on fluids. He or she also may suggest adjusting your diuretic use to increase the level of sodium in your blood.Severe hyponatremia can be treated by infusing a solution of 5% sodium chloride in water into the bloodstream. Moderate is due to use of diuretics or an abnormal increase in vasopressin is often treated by instructions to drink less water each day. Hyponatremia due to adrenal gland insufficiency is treated with hormone injections.When hyponatremia is severe it is considered a medical emergency that is treated in a hospital. The doctor will slowly increase the blood sodium levels with intravenous (IV) fluids. Additional treatment depends upon the underlying cause of hyponatremia.If you take diuretics, make sure you have your blood sodium levels checked on a regular basis. If you are sick and symptoms include vomiting or diarrhea, follow your doctor's recommendations for replacing lost fluids with clear liquids or electrolyte replacement fluids.People who run marathons and train intensely should drink electrolyte replacement fluids to keep sodium levels balanced.DISCLAIMER: This information should not substitute for seeking responsible, professional medical care. 


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