Abstract
Hyponatremia is a commonly encountered clinical problem by all physicians. It is classified according to volume status as hypovolemic, euvolemic, or hypervolemic hyponatremia. The clinical presentation depends on the type of hyponatremia and the speed of onset. Acute hyponatremias can result in altered sensorium, convulsions, and coma, making it a medical emergency. Chronic hyponatremias can be due to drugs and several systemic illnesses. The syndrome of inappropriate secretion of antidiuretic hormone is common and can occur in several diseases as euvolemic hyponatremia. Its onset can be deceptively slow but needs attention to prevent complications. Investigations of serum and urine, osmolality and sodium, help in classification of this condition. Apart from intravenous correction with hypertonic saline, which may be urgently needed in acute hyponatremia to prevent mortality, vaptans offer an oral option in chronic hyponatremia. Care must be taken to avoid rapid correction of serum sodium, to prevent osmotic demyelination syndrome.
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