Differential diagnosis of hyponatremia and hypernatremia
Authors:
Otakar Pšenička; Jarmila Křížová
Authors‘ workplace:
3. interní klinika 1. LF UK a VFN, Praha
Published in:
Vnitř Lék 2022; 68(E-8): 23-28
Category:
Differential Diagnosis Column or What You Can Be Asked at a Postgraduate Certification Exam
doi:
https://doi.org/doi.org/10.36290/vnl.2022.118
Overview
Dysnatremias are among the most common mineral imbalances encountered in clinical practice. Both hyponatremia and hypernatremia are associated with increased morbiditidy and mortality and represent negative prognostic factors regardless of their cause. Serum osmolality, extracellular fluid volume and sodium urine concentration are important parameters for evaluation the cause and differential diagnosis. The rate of onset of ionic disorder and severity of clinical symptoms are essential. While acute disorders with symptoms are treated immediately, in chronic disorders, thorough diagnostic evaluation and a careful approach to their correction are necessary. Especially with rapid substitution of chronic hyponatremia, there is a risk of osmotic demyelination syndrome. Therefore, a slow correction of the serum sodium level with frequent mineralogram checks is required.
Keywords:
hyponatremia – SIADH – hypernatremia – osmolality – osmotic demyelination syndrome
Sources
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Diabetology Endocrinology Internal medicineArticle was published in
Internal Medicine
2022 Issue E-8
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