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Related Experiment Video

Updated: May 3, 2026

Evaluation of Hydration Status by Bioelectrical Impedance Vector Analysis in Patients with Ischemic Heart Disease Undergoing Exercise Stress Test

Evaluation of Hydration Status by Bioelectrical Impedance Vector Analysis in Patients with Ischemic Heart Disease Undergoing Exercise Stress Test

Published on: September 22, 2023

Pseudohyponatremia: does it matter in current clinical practice?

¹Department of Internal Medicine and Institute of Biomedical Sciences, Hanyang University College of Medicine, Seoul, Korea.

Electrolyte & Blood Pressure : E & BP

|January 25, 2014

Summary

Pseudohyponatremia occurs when high protein or lipid levels falsely lower measured serum sodium. Direct potentiometry offers accurate sodium measurement in serum water, unlike indirect methods.

Keywords:

Hyperlipidemia Hyperproteinemia Intravenous immunoglobulin Potentiometry Pseudohyponatremia Sodium-selective electrode

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Standardized Measurement of Nasal Membrane Transepithelial Potential Difference NPD

Standardized Measurement of Nasal Membrane Transepithelial Potential Difference NPD

Published on: September 13, 2018

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Last Updated: May 3, 2026

Evaluation of Hydration Status by Bioelectrical Impedance Vector Analysis in Patients with Ischemic Heart Disease Undergoing Exercise Stress Test

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Published on: September 22, 2023

Standardized Measurement of Nasal Membrane Transepithelial Potential Difference NPD

Standardized Measurement of Nasal Membrane Transepithelial Potential Difference NPD

Published on: September 13, 2018

Area of Science:

Clinical Chemistry
Biochemistry

Background:

Serum comprises 93% water and 7% non-aqueous components (lipids, proteins).
Sodium is primarily distributed within serum water.

Observation:

Hyperproteinemia and hyperlipidemia increase non-aqueous components, reducing the water proportion.
Flame photometry measures sodium in whole plasma, leading to pseudohyponatremia.
Sodium-selective electrodes measure sodium activity in serum water, providing true concentration.

Findings:

Indirect potentiometry dilutes samples, potentially causing inaccurate sodium readings.
Direct potentiometry provides accurate serum sodium concentration by avoiding dilution.
Indirect potentiometry rarely shows significantly low sodium in hyperlipidemic/hyperproteinemic states.

Implications:

Clinicians must consider potential errors in indirect potentiometry for serum sodium measurement.
Direct potentiometry is preferred for accurate sodium assessment in specific patient populations.
Current indirect methods may be acceptable if awareness of potential errors is maintained.