Hyponatremia: pathophysiology, classification, manifestations and management

Hyponatremia has complex pathophysiology, is frequent and has potentially severe clinical manifestations, and its treatment is associated with high risks. Hyponatremia can be hypertonic, isotonic or hypotonic. Hypotonic hyponatremia has multiple etiologies, but only two general mechanisms of develop...

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Bibliographic Details
Published in:International urology and nephrology 2014-11, Vol.46 (11), p.2153-2165
Main Authors: Rondon-Berrios, Helbert, Agaba, Emmanuel I., Tzamaloukas, Antonios H.
Format: Article
Language:English
Subjects:
Disease Management
Humans
Hyponatremia - classification
Hyponatremia - physiopathology
Hyponatremia - therapy
Medicine
Medicine & Public Health
Nephrology
Nephrology - Review
Osmolar Concentration
Sodium - blood
Urology
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Summary:Hyponatremia has complex pathophysiology, is frequent and has potentially severe clinical manifestations, and its treatment is associated with high risks. Hyponatremia can be hypertonic, isotonic or hypotonic. Hypotonic hyponatremia has multiple etiologies, but only two general mechanisms of development, defective water excretion, usually because of elevated serum vasopressin levels, or excessive fluid intake. The acute treatment of symptomatic hypotonic hyponatremia requires understanding of its targets and risks and requires continuous monitoring of the patient’s clinical status and relevant serum biochemical values. The principles of fluid restriction, which is the mainstay of management of all types of hypotonic hyponatremia, should be clearly understood and followed. Treatment methods specific to various categories of hyponatremia are available. The indications and risks of these treatments should also be well understood. Rapid correction of chronic hypotonic hyponatremia may lead to osmotic demyelination syndrome, which has severe clinical manifestations, and may lead to permanent neurological disability or death. Prevention of this syndrome should be a prime concern of the treatment of hypotonic hyponatremia.
ISSN:0301-1623
1573-2584
DOI:10.1007/s11255-014-0839-2