Clinico-aetiological profile of hyponatremia in adults

Abstract

Hyponatremia is a common electrolyte abnormality observed in hospitalised patients. Hyponatremia is usually under diagnosed and the management is often inadequate and inappropriate. The aetiology, clinical behaviour and the prognosis of hyponatremia vary widely from hospital to hospital. Patients with surgical illness, head injury and post-operative patients were excluded from the study. A total of sixty consecutive cases of hyponatremia were taken for retrospective study and sixty cases for prospective study. In all these cases detailed history taken and thorough clinical examination was done as per protocol attached. Relevant investigations were done as per the protocol, base line random blood sugar, urea, creatinine, fasting lipid profile were measured. Serum sodium levels were monitored till it became normal. The mean age of presentation is 57 years. Drowsiness was commonest symptom (60 patients, 53.2%) followed by vomiting, hiccoughs and seizures. Nearly half of the patients (58 patients, 48.3%) had euvolemic hyponatremia. Less than half o f the patients (47 patients, 39%) had hypovolemic hyponatremia. SIADH was the commonest cause of hyponatremia (46 patients, 38.3%) followed by salt loosing nephropathy (32 patients. 26. 7%). Hyponatremia is common in elderly. Severity of hyponatremia becomes greater as the age advances. Drowsiness is the common symptom. Seizures are present only in severe hyponatremia. Over all the commonest cause of hyponatremia is SIADH