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Electrolytes: Sodium Disorders.
FP Essent 2017; 459:11-20FE

Abstract

Sodium disorders (ie, hyponatremia, hypernatremia) are common electrolyte disturbances in clinical medicine and are associated with increased rates of morbidity and mortality. Etiologies of hyponatremia are classified into four categories. The first is pseudohyponatremia, in which the sodium level is low due to hyperproteinemia, hyperlipidemia, or hyperglycemia. The other three categories are based on overall patient fluid status and include hypovolemic (commonly due to fluid loss), hypervolemic (commonly due to fluid retention from heart failure, cirrhosis, or renal failure), and euvolemic (most often because of syndrome of inappropriate secretion of antidiuretic hormone). Hypovolemic hyponatremia is managed by rehydration with isotonic saline. Hypervolemic hyponatremia is managed by addressing the underlying cause. Euvolemic hyponatremia is managed by restricting free water intake, addressing the underlying cause, and occasionally with drugs (eg, vasopressin receptor antagonists). Patients with severe or acutely symptomatic hyponatremia (eg, altered mental status, seizures), including those with acute symptomatic exercise-induced hyponatremia, require urgent treatment. This should consist of hypertonic saline administration along with monitoring of sodium levels to avoid overly rapid correction. Hypernatremia most often occurs because of water loss or inadequate water intake. Depending on severity, management involves oral or intravenous hypotonic fluids and addressing the underlying cause.

Authors+Show Affiliations

Madigan Army Medical Center Family Medicine Residency, 9040 Jackson Ave, Tacoma, WA 98431.Womack Army Medical Center, 2817 Reilly Road, Fort Bragg, NC 28310.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

28806046

Citation

Braun, Michael M., and Megan Mahowald. "Electrolytes: Sodium Disorders." FP Essentials, vol. 459, 2017, pp. 11-20.
Braun MM, Mahowald M. Electrolytes: Sodium Disorders. FP Essent. 2017;459:11-20.
Braun, M. M., & Mahowald, M. (2017). Electrolytes: Sodium Disorders. FP Essentials, 459, pp. 11-20.
Braun MM, Mahowald M. Electrolytes: Sodium Disorders. FP Essent. 2017;459:11-20. PubMed PMID: 28806046.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Electrolytes: Sodium Disorders. AU - Braun,Michael M, AU - Mahowald,Megan, PY - 2017/8/15/entrez PY - 2017/8/15/pubmed PY - 2017/11/1/medline SP - 11 EP - 20 JF - FP essentials JO - FP Essent VL - 459 N2 - Sodium disorders (ie, hyponatremia, hypernatremia) are common electrolyte disturbances in clinical medicine and are associated with increased rates of morbidity and mortality. Etiologies of hyponatremia are classified into four categories. The first is pseudohyponatremia, in which the sodium level is low due to hyperproteinemia, hyperlipidemia, or hyperglycemia. The other three categories are based on overall patient fluid status and include hypovolemic (commonly due to fluid loss), hypervolemic (commonly due to fluid retention from heart failure, cirrhosis, or renal failure), and euvolemic (most often because of syndrome of inappropriate secretion of antidiuretic hormone). Hypovolemic hyponatremia is managed by rehydration with isotonic saline. Hypervolemic hyponatremia is managed by addressing the underlying cause. Euvolemic hyponatremia is managed by restricting free water intake, addressing the underlying cause, and occasionally with drugs (eg, vasopressin receptor antagonists). Patients with severe or acutely symptomatic hyponatremia (eg, altered mental status, seizures), including those with acute symptomatic exercise-induced hyponatremia, require urgent treatment. This should consist of hypertonic saline administration along with monitoring of sodium levels to avoid overly rapid correction. Hypernatremia most often occurs because of water loss or inadequate water intake. Depending on severity, management involves oral or intravenous hypotonic fluids and addressing the underlying cause. SN - 2159-3000 UR - https://www.unboundmedicine.com/medline/citation/28806046/Electrolytes:_Sodium_Disorders DB - PRIME DP - Unbound Medicine ER -