Tuesday, December 10, 2019

Classification and causes of hyponatremia mnemonics + notes


Classification and causes of hyponatremia mnemonics + notes:

1. Hyponatremia with low osmolality :
     (i) reduced effective blood volume
              (A) increased ECF volume -
                               - Edematous kidney (nephrotic syndrome)
                               - Cirrhosis of liver
                               - Failure of heart

              (B) REduced ECF volume -
                                - Renal loss of Na ( Diuretics, Ketonuria, Addison's disease)
                                - Extrarenal loss of Na ( sweating, diarrhea, vomiting, peritonitis, pancreatitis)

    (ii) Normal/ increased EBV
                - Inadequate ADH syndrome
                - Constant thirst
                - Renal failure (chronic)

2. Hyponatremia with raised osmolality :
( H & M)
- Hyperglycemia 
- Mannitol administration 

Note -
- Hyponatremia per se does not produce any significant clinical features. The low osmolality that it causes is responsible for various features.
- Slow correction of hypotonicity produces gradual rise in osmolality without any significant risk. But rapid correction of hyponatremia produces loss of brain water resulting in brain damage!
- The rate of correction should be around 0.6 mEq/L/hr. In severely symptomatic patients, total correction in a day should not exceed 8-10 mEq/L/hr.

That's all
Hope it helps
- Jaskunwar Singh

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