Management and diagnosis of hyponatremia

Hyponatremia is an electrolyte disorder that occurs when the concentration of sodium in the blood is well below what is considered normal. Sodium is an electrolyte whose main function is to help regulate the amount of water in and around cells.

On severe occasions, this disorder can cause significant damage. When this happens, the body's water levels increase and the cells swell. In this way many health problems originate. Do you know its management and diagnosis?

Symptoms of hyponatremia

Symptoms of hyponatremia may vary depending on the severity of the disease.

As detailed by a file of Endocrine ConnectionsThe symptoms of hyponatremia can vary in each patient, depending on the evolution of the disorder. In any case, even if they seem slight, It is best to seek medical attention as soon as the disease is suspected. Clinical manifestations include:

  • Nausea and vomiting
  • Headache.
  • Disorientation.
  • Agitation and irritability.
  • Seizures
  • Loss of energy and tiredness.
  • Coma.

The patients who present Chronic hyponatremia may present with symptoms such as nausea, vomiting, cramps, visual disturbances, headaches, seizures and coma. It is not very well known why, but hyponatremia is more common in young women and adolescents of both sexes.

Also read: Furosemide and its diuretic action in our body

Causes and risk factors

Sodium is necessary to maintain normal blood pressure, collaborate in the proper functioning of muscles and nerves, while regulating the balance of fluids in the body. Hyponatremia occurs when the sodium level is below 135 milliequivalents per liter. The normal level is between 135 and 145 milliequivalents per liter.

Some lifestyles and many diseases can cause hyponatremia, including the following:

  • Medicines: Medications such as some diuretics, antidepressants and analgesics can interfere with kidney and hormonal processes that keep sodium levels at healthy levels.
  • Heart, kidney and liver problems: Congestive heart failure and diseases that affect the kidneys or liver can cause fluid to build up in the body. For this reason the sodium is diluted and the total level decreases.
  • Syndrome of inappropriate secretion of the anti hormonediuretic: This condition causes the body to retain more water instead of excreting it normally in the urine.
  • Chronic vomiting or diarrhea and other causes of dehydration.
  • Drink excess water: This excess water can exceed the ability of the kidneys to excrete water.
  • Hormonal alterations: Adrenal insufficiency affects the ability of the adrenal glands to produce hormones that help maintain the balance of sodium, potassium and water.
  • Age: Older adults may have more risk factors that contribute to hyponatremia.
  • Intense physical activities: People who drink too much water while practicing very intense activities are at greater risk of hyponatremia.

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Laboratory tests are necessary to diagnose hyponatremia.

The diagnostic process of hyponatremia is complex and requires several laboratory tests, as indicated by a publication of the Indian Journal of Endocrinology and Metabolism. For confirm the existence of hyponatremia It will be necessary to do:

  • A good history.
  • Physical examination of the patient assessing signs of edema and dehydration.
  • Determination of ions in blood and urine.
  • Osmolarity in blood and urine.

Depending on the extracellular volume, three groups are distinguished:

  • Hypovolemia: dehydration can be observed.
  • Normovolemia: the level of sodium is slightly increased.
  • Hypervolemia: edema is seen.

In chronic hyponatremia, sodium levels gradually decrease for 48 hours or more. However, symptoms and complications are usually more moderate. In contrast, in acute hyponatremia, sodium levels decrease rapidly, resulting in potentially more serious effects.


When possible, the treatment of hypothermia is directed to the underlying cause. If it is moderate and chronic hyponatremia due to food, diuretics or excessive water consumption, The recommendation to follow will be the decrease in fluid consumption.

However, in other cases, the diuretic regimen must be readjusted in order to increase the level of sodium in the blood. If the hyponatremia is severe and acute, the treatment will be more aggressive, and will be administered in hospital centers.

Some of the possible options are:

  • IV fluids: In these cases, an intravenous sodium solution is administered to slowly increase the levels of sodium in the blood. It must be controlled so that it is slow because if it is corrected too quickly it can be dangerous.
  • Treatment pharmacological: Drugs are prescribed to control the signs and symptoms of hyponatremia such as headaches, nausea and seizures.

In conclusion, hyponatremia is a disorder that carries considerable risks. Therefore, before any manifestation of the same it is essential to go to the doctor to receive a timely diagnosis and treatment.