Jiménez-Vega AR, Carrillo-Pérez DL, Carrillo-Maravilla E

Idioma: Español
Referencias bibliográficas: 60
Paginas: 141-150
Archivo PDF: 211.51 Kb.

RESUMEN

La hiponatremia es la principal alteración electrolítica observada en la práctica clínica, es de etiología multifactorial, y resultado de una alteración en la excreción de agua por niveles elevados de vasopresina en combinación con ingesta de agua libre. La vasopresina se incrementa por diversas condiciones clínicas frecuentes, como la secreción inadecuada de hormona antidiurética, estados de depleción del volumen arterial efectivo circulante, estados postoperatorios, trastornos del sistema nervioso central y trauma. Esta condición puede explicar una gran variedad de síntomas clínicos, desde leves a graves e incluso mortales. La presencia de signos o síntomas de encefalopatía hiponatrémica obligan a tratamiento previo al diagnóstico etiológico. Esta revisión enfatiza el abordaje diagnóstico sistematizado basado en pruebas de laboratorio (cálculo de brecha osmolal, osmolaridad urinaria, sodio urinario, fracción excretada de sodio, urea y ácido úrico) útiles en la diferenciación de los diferentes tipos de hiponatremia, modalidades de tratamiento y métodos de corrección apropiados en las diferentes entidades que cursan con este frecuente desequilibrio hidroelectrolítico.

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