Hyponatraemia: etiology, management and outcome

Area of Science:

• Internal Medicine
• Nephrology
• Clinical Pharmacology

Background:

• Hyponatraemia (low serum sodium) is a prevalent electrolyte imbalance, particularly in elderly patients.
• Understanding its diverse etiologies and management outcomes is critical for effective clinical practice.

Purpose of the Study:

• To investigate the causes, treatments, and outcomes of hyponatraemia in a tertiary care hospital.
• To identify common etiological factors and assess treatment strategies.

Main Methods:

• A case series design was employed, reviewing records of 220 patients admitted with serum sodium levels ≤130 mmol/L.
• Data collected included demographics, clinical presentation, laboratory values, diagnoses, treatments, and outcomes.
• Statistical analysis was performed using SPSS version 11.0.

Main Results:

• Hyponatraemia affected 220 patients (mean age 65 years), with neurological symptoms in 25%.
• Medications (diuretics, ACE inhibitors, ARBs) were the leading cause (30%), followed by gastrointestinal losses (25%) and chest infections (11%).
• The mortality rate was 6.8%, with a recommended serum sodium correction rate of <10 mmol/L/24 hours.

Conclusions:

• Elderly patients are more susceptible to hyponatraemia, with gastrointestinal losses and drug use as primary drivers.
• Treatment should focus on addressing the underlying cause, and Syndrome of Inappropriate Antidiuretic Hormone (SIADH) requires specific diagnostic investigation.
• Gradual correction of serum sodium levels is advised to prevent complications.