Hyponatremia Under Various Specialties

Abstract

Purpose: Hyponatremia is frequently observed electrolytes derangement in both medical and surgical specialties with a variety of underlying illnesses. The rapidity of sodium derangement and symptoms at the time of presentation help to decide its management plan. Many times, treating primary disease specifically along with just conservative steps for hyponatremia i.e., plain water restriction, adding salt, or infusion isotonic saline help achieve desirable results. Patients and methods: This observational study was conducted at the Indus Hospital and Health Network (IHHN) from July 2017 to April 2020 with the approval of Interactive and Research Development (IRB-IRD). All those (age >14 years) of either gender, admitted under various specialties with hyponatremia (serum sodium<135 meq/L) were enrolled after taking consent. Their history, demographics, volume status, and investigation were done and hyponatremia was categorized as mild (130 to 134 meq/L), moderate (125 to 129 meq/L), and severe (<125 meq/L). The outcome was noted on the pre-formed questionnaire as Sodium improve/ unimproved, discharged, expired. Results: Out of 262 patients with a male to female ratio of 0.8/1 (123/139), the most prevalent comorbid was hypertension 177 (67.6%), followed by CKD 171 (65.3%) and DM 142 (54.2%). The majority 102 (38.9%) had a moderate degree of hyponatremia while hypovolemia was the predominant volume status observed in 131 (50%) patients. Symptomatic hyponatremia was present in 38 (14.5%) patients. The majority of patients recovered and discharged 234 (89.3%), of which only 2 patients required hypertonic saline.