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2014, Number 2

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Rev Med MD 2014; 5.6 (2)

Hyponatremia: diagnostic approach and treatment

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

Language: Spanish
References: 60
Page: 141-150
PDF size: 211.51 Kb.


ABSTRACT

Hyponatremia is the most common electrolyte disturbance in clinical scenarios. The etiology of this condition is multifactorial, and is caused by an alteration in the water excretion due to high levels of vasopressin and free water ingestion. Vasopressin levels increases in various scenarios like inappropriate antidiuretic hormone secretion syndrome, effective circulating volume depletion, postsurgical states, central nervous system alterations and trauma. This condition may explain a variety of clinical syndromes that range from mild to severe and even mortal conditions. Treatment must be given before investigating the main cause in the presence of signs and symptoms of hyponatremic encephalopathy.
This review emphasizes the importance of systematic approach based on laboratory tests (osmolal gap, urinary osmolality, urinary sodium, uric acid, urea and sodium excretion fraction). These tests are of extreme importance to classify treat and correct appropriately the different entities associated to hyponatremia.


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