![]() ![]() Based on Edelman’s equation serum sodium is approximately the sum of exchangeable sodium Na e + and potassium K e + divided by total body water (TBW). Sodium is the main cation in the extracellular fluid and the main contributor (with its accompanying anion: chloride or bicarbonate)to serum osmolality. Water is increased in the extracellular compartment relative to sodium, and the body’s ability to excrete excess water is impaired. Obstructive jaundice due to high level of lipoprotein X (LpX)įor the purpose of this discussion, hyponatremia refers to hyponatremia with hypoosmolality (hypotonic hyponatremia). It is seen in certain clinical scenarios such as:Ĭ. Pseudohyponatremia: is rare and is avoided by measuring sodium by direct ion-selective electrode. No shift of water from the intracellular space occurs.Ĥ. Isotonic hyponatremia (plasma osmolality is normal 280-295 mOsm/kg H 2O): is encountered after some urological and gynecological surgeries due to absorption of sodium-free irrigation solutions such as mannitol, sorbitol or glycine which expand extracellular fluid space. Water shifts from the intracellular to the extracellular compartment.ģ. Hypotonic hyponatremia (plasma osmolality 295 mOsm/kg H 2O): serum osmolality is high, and serum sodium is low as in hyperglycemia and administration of intravenous immune globulin (IVIG suspended in disaccharide such as sucrose). Hyponatremia can be hypotonic, hypertonic or isotonic. Hyponatremia, Hypernatremia, Water balance, Electrolyte disorder The review will conclude with clinical cases that apply the discussed principles in diagnosis and treatment. Complex tables, flow charts and algorithms will be avoided. The following review will cover the most salient aspects of hyponatremia and hypernatremia and provide the clinician with a practical guide to the diagnosis and treatment. Hypernatremia is associated with high mortality due to associated co-morbid conditions even after successful correction. ![]() Quick and uncontrolled correction of chronic hyponatremia may lead to severe clinical consequences. Even mild hyponatremia is associated with many non-specific symptoms and may quickly evolve into severe hyponatremia. Most of hyponatremia and hypernatremia cases are mild but they are clinically significant. Hyponatremia is defined as serum sodium 145 mEq/l (mmol/l). (Acessed 01 March 2021)įood Switch 2021.Hyponatremia and hypernatremia are disorders of water balance and are very common especially in hospitalized patients. Getting your salt intake right – AXA Healthĭiet and nutrition centre - AXA Health Useful resources Sources and further readingĭehydration – Know your risk – AXA Health You’ll find lots of information and help with all of these in the Healthy lifestyle pages on our website.Īnswered by the Health at Hand nurses. These include staying hydrated, reducing your salt intake and exercising. There are a number of ways to reduce sodium levels in your blood. Symptoms of high sodium levels in the blood can include:
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