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Encyclopedia > Hyponatremia
ICD-10 E871
ICD-9 276.1

The electrolyte disturbance hyponatremia or hyponatraemia exists in humans when the sodium level in the plasma falls below 135 mmol/l. At lower levels water intoxication may result, an urgently dangerous condition. Hyponatremia is an abnormality that can occur in isolation or, as most often is the case, as a complication of other medical illnesses. In the case of other mammals, particularly agricultural animals, different indications are relevant. The following refers to humans; an introduction to the sodium deficiency is appended for bovines. The following codes are used with International Statistical Classification of Diseases and Related Health Problems. ... // E00-E35 - Endocrine diseases (E00-E07) Disorders of thyroid gland (E00) Congenital iodine-deficiency syndrome (E01) Iodine-deficiency-related thyroid disorders and allied conditions (E02) Subclinical iodine-deficiency hypothyroidism (E03) Other hypothyroidism (E030) Congenital hypothyroidism with diffuse goitre (E031) Congenital hypothyroidism without goitre (E032) Hypothyroidism due to medicaments and other... The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ... Electrolyte disturbance refers to an abnormal change in the levels of electrolytes in the body. ... General Name, Symbol, Number sodium, Na, 11 Chemical series alkali metals Group, Period, Block 1, 3, s Appearance silvery white Atomic mass 22. ... Blood plasma is the liquid component of blood, in which the blood cells are suspended. ... Water intoxication (also known as hyperhydration or water poisioning) is a potentially fatal medical condition in which an individuals intake of water exceeds a safe amount. ...



Most patients are asymptomatic of the hyponatremia, but usually have symptoms related to the underlying cause. This is pretty gay. The term symptom (from the Greek syn = con/plus and pipto = fall, together meaning co-exist) has two similar meanings in the context of physical and mental health: Strictly, a symptom is a sensation or change in health function experienced by a patient. ...

Severe hyponatremia may cause osmotic shift of water from the plasma into the brain cells. Typical symptoms include nausea, vomiting, headache and malaise. As the hyponatremia worsens, confusion, stupor or coma may occur. Osmosis is the diffusion of water through a selectively-permeable membrane from a region of high solvent potential to a region of low solvent potential. ... Comparative brain sizes In animals, the brain, or encephalon (Greek for in the head), is the control center of the central nervous system. ... Cells in culture, stained for keratin (red) and DNA (green). ... For other uses, see Nausea (disambiguation). ... Vomiting (or emesis) is the forceful expulsion of the contents of ones stomach through the mouth. ... A headache (medically known as cephalgia) is a condition of mild to severe pain in the head; sometimes neck or upper back pain may also be interpreted as a headache. ... Malaise is a term used to refer to a general state of discomfort, tiredness, or illness. ... This article is being considered for deletion in accordance with Wikipedias deletion policy. ... In medicine, a coma (from the Greek koma, meaning deep sleep) is a profound state of unconsciousness. ...


An abnormally low plasma sodium level is best considered in conjunction with the person's plasma osmolarity and extracellular fluid volume status. Osmolality, in biology and chemistry, is a measure of moles of solute per kg of water. ... In some animals, including mammals, the two types of extracellular fluids are interstitial fluid and blood plasma. ...

Most cases of hyponatremia are associated with reduced plasma osmolarity. In fact, the vast majority of adult cases are due to increased ADH activity (ADH being a hormone that causes water, but not salt, retention). Hence, the patient with hyponatremia can be viewed as the patient with increased ADH activity. It is the physician's task to identify the cause of the increased ADH activity in each case. Plasma osmolality is the osmolality of human blood. ...

In patients who are volume depleted (i.e. their blood volume is too low), ADH secretion is increased (since volume depletion is a potent stimulus for ADH secretion). As a result, the kidneys of such patients hold on to water and produce a very concentrated urine. Treatment is simple (if not without risk) - simply restore the patient's blood volume thereby turning off the stimulus for ongoing ADH release and water retention.

Some patients with hyponatremia have normal blood volume. In those patients, the increased ADH activity and subsequent water retention may be due to "physiologic" causes of ADH release such as pain or nausea. Alternatively, they may have the Syndrome of Inappropriate ADH (SIADH). SIADH represents the sustained, non-physiologic release of ADH and most often occurs as a side effect of certain medicines, lung problems such as pneumonia or abscess, brain disease, or certain cancers (most often small cell lung carcinoma).

A third group of patients with hyponatremia are often said to be "hypervolemic". They are identified by the presence of peripheral edema. In fact, the term "hypervolemic" is misleading since their blood volume is actually low. The edema underscores the fact that fluid has left the circulation (i.e. the edema represents fluid that has exited the circulation and settled in dependent areas). Since such patients do, in fact, have reduced blood volume, and since reduced blood volume is a potent stimulus for ADH release, it is easy to see why they have retained water and become hyponatremic. Treatment of these patients involves treating the underlying disease that caused the fluid to leak out of the circulation in the first place. In many cases, this is easier said then done when one recognizes that the responsible underlying conditions are diseases such as liver cirrhosis or heart failure - conditions that are notoriously difficult to manage, let alone cure.

It is worth considering separately, the hyponatremia that occurs in the setting of diuretic use. Patients taking diuretic medications such as furosemide (Lasix), hydrochlorothiazide, chlorthalidone, etc., become volume depleted. That is to say that their diuretic medicine, by design, has caused their kidneys to produce more urine than they would otherwise make. This extra urine represents blood volume that is no longer there, that has been lost from the body. As a result, their blood volume is reduced. As mentioned above, lack of adequate blood volume is a potent stimulus for ADH secretion and thence water retention.

A recent surge in death from hyponatremia has been attributed to overintake of water while under the influence of MDMA. ecstasy and religious ecstasy MDMA, most commonly known today by the street name ecstasy, is a synthetic entactogen of the phenethylamine family whose primary effect is to stimulate the brain to rapidly secrete large amounts of serotonin, causing a general sense of openness, empathy, energy, euphoria, and well-being. ...


A normal or high plasma osmolarity with hyponatremia is called pseudohyponatremia. Pseudohyponatremia may be caused if high lipid levels in the plasma interfere with the sodium assay, or if a different solute (such as glucose) is abnormally abundant. Figure 1: Structure of a Lipid. ... An assay is a procedure where the concentration of a component part of a mixture is determined. ... Glucose (Glc), a monosaccharide (or simple sugar), is one of the most important carbohydrates. ...

Hypoosmolar hyponatremia

When the plasma osmolarity is low, the extracellular fluid volume status may be in one of three states:

Treat underlying cause and give IV isotonic saline. It is important to note that sudden restoration of blood volume to normal will turn off the stimulus for continued ADH secretion. Hence, a prompt water diuresis will occur. This can cause a sudden and dramatic increase the serum sodium concentration and place the patient at risk for so-called 'central pontine myelinolysis" (CPM). That disorder is characterized by major neurologic damage, often of a permanent nature. SWEAT is an OLN/TSN show hosted by Julie Zwillich that aired in 2003-2004. ... In medicine, a burn is a type of injury to the skin caused by heat, electricity, chemicals, or radiation (an example of the latter is sunburn). ... Vomiting (or emesis) is the forceful expulsion of the contents of ones stomach through the mouth. ... Diarrhea (American English) or diarrhoea (Commonwealth English) is a condition in which the sufferer has frequent and watery, chunky, or loose bowel movements (from the ancient Greek word διαρροή = leakage; lit. ... Urine is liquid waste excreted by the kidneys and is produced by the process of filtration. ... A diuretic is any drug that elevates the rate of bodily urine excretion. ... Thiazides are a class of drug that promote water loss from the body ((diuretics)). They inhibit Na+/Cl- reabsorption from the distal convoluted tubules in the kidneys. ... Addisons disease (also known as chronic adrenal insufficiency, or hypocortisolism) is a rare endocrine disorder. ... Cerebral salt-wasting syndrome (CSWS) is a disease featuring hyponatremia (low blood sodium levels) and dehydration in response to disease processes in or surrounding the brain. ... Human kidneys viewed from behind with spine removed The kidneys are bean-shaped excretory organs in vertebrates. ...

Because of the risk of CPM, patients with low volume hyponatremia may eventually require water infusion as well as volume replacement. Doing so lessens the chance of a too rapid increase of the serum sodium level as blood volume rises and ADH levels fall.

  • Normal volume.
    • SIADH (syndrome of inappropriate antidiuretic hormone)
    • Some cases of psychogenic polydipsia

For SIADH, you can give demeclocycline, an ADH antagonist. The syndrome of inappropriate antidiuretic hormone (SIADH) is a condition commonly found in the hospital population, especially in patients being hospitalized for central nervous system (CNS) injury. ... Polydipsia is a medical term meaning abnormally large (poly-) intake of fluids by mouth. ... The syndrome of inappropriate antidiuretic hormone (SIADH) is a condition commonly found in the hospital population, especially in patients being hospitalized for central nervous system (CNS) injury. ... Demeclocycline (marketed as Declomycin®, Declostatin® and Ledermycin®) is a tetracycline antibiotic used in various types of bacterial infections. ...

Place the person on water restriction. Congestive heart failure (CHF), also called congestive cardiac failure (CCF) or just heart failure, is a condition that can result from any structural or functional cardiac disorder that impairs the ability of the heart to fill with or pump a sufficient amount of blood throughout the body. ... Hypothyroidism is the disease state caused by insufficient production of thyroid hormone by the thyroid gland. ... In medicine, adrenal insufficiency (or hypocortisolism) is the inability of the adrenal gland to produce adequate amounts of cortisol in response to stress. ... The liver is the largest internal organ of the human body. ... Cirrhosis is a consequence of chronic liver disease characterized by replacement of liver tissue by fibrotic scar tissue as well as regenerative nodules, leading to progressive loss of liver function. ... Psychogenic polydipsia is a special form of polydipsia, caused by mental disorders. ...

Severe hyponatremia may result from a few hours of heavy exercise in high temperature conditions, such as hiking in desert areas, or from endurance athletic events when electrolytes are not supplied. (Such an incident notably happened to long-distance athlete Craig Barrett in 1998). Craig Barrett (born 16 November 1971) is a New Zealand athlete specializing in long distance events. ... 1998 (MCMXCVIII) was a common year starting on Thursday of the Gregorian calendar, and was designated the International Year of the Ocean. ...

Animals: Bovines

Sodium deficiency exists in grazing animals where soil sodium levels have been depleted by leeching. This is more common in mountainous regions. Agricultural science research conducted in the northern Thai highlands in the 1970s found that an endemic sodium deficiency masked all other nutrient deficiencies across all seasons and reduced productivity. Sodium supplementation increased liveweight gain by around 30% and also reproductive rates by around 30%. Simple salt supplementation is now recommended in this region and neighbouring mountains, as both a herd management tool and for increased productivity (see sources below). The electrolyte disturbance hyponatremia exists when the sodium level in the plasma falls below 135 mmol/l. ... Agricultural science is a broad multidisciplinary field that encompasses the parts of exact, natural, economic, and social sciences that are used in the practice and understanding of agriculture. ... The Thai Highlands are mountains in the north of Thailand that extend through Lao-PDR, Burma and China to link to the Himalayas, of which they may be considered foothills. ...

See also

Water intoxication (also known as hyperhydration or water poisioning) is a potentially fatal medical condition in which an individuals intake of water exceeds a safe amount. ... Hypernatremia is a medical condition in which there is excess sodium, urea, and other electrolytes in the body relative to the amount of water. ...


  Results from FactBites:
Hyponatremia (530 words)
Hyponatremia 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 underactive adrenal glands excrete too much sodium.
Hyponatremia is diagnosed by measuring the sodium levels in a blood sample.
Mild hyponatremia is treated by reducing your intake of water and monitoring the use of diuretics.
  More results at FactBites »



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