Etiology, Clinical Profile and Outcome of Symptomatic Hyponatremia - A Hospital Based Study

• DOI: 10.52403/gijhsr.20220702
• Publication Date: 2023-03-30T07:11:23Z
• Authors: Asma Rafi; Muzaffar Maqbool

Background: Hyponatremia (serum sodium < 135 mEq/litre) is one of the most common electrolyte abnormalities in hospitalised patients. It is more common in elderly, multi-morbid patients taking multiple medications and in those having lack of access to food and water. Prognosis in such patients depends upon the severity and underlying condition causing it. It therefore becomes imminent to identify the etiology of hyponatremia and also to correct it at an appropriate pace (10-12mEq/litre/day) such that a drastic neurological outcome is averted. Aims and Objectives: To study the clinico-etiological profile in admitted patients of hyponatremia in a tertiary care hospital of North India and their in-hospital outcome. Study Design: A hospital-based observational study. Materials and Methods: A total of 250 patients were studied over a period of 18 months. Detailed clinical and drug history, physical examination, assessment of volume status, routine baseline biochemical parameters, spot urinary sodium followed by paired urine and serum osmolality was done in all patients. Results: The mean age of patients was 62.4 years with a male to female ratio of 1:1.6. GI symptoms like nausea and vomiting was the most common symptom seen in 60% of patients. Commonest neurological complaints were confusion (52%) followed by lethargy (22%), seizures (18%) and coma (8%). Diuretic use was the most common cause of hyponatremia (36%) followed by SIADH (26%) and GI losses (10%). 52% patients were euvolemic, 40% were hypervolemic and 8% were hypovolemic. Mortality in our study was 14%. Conclusion: From our study, we concluded that diuretics are the most common cause of hyponatremia followed by SIADH, with a significant mortality in euvolemic type of hyponatremia.

Keywords: Hyponatremia, Diuretics, Euvolemic, Hypervolemic, Hypovolemic, SIADH.