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The level of sodium inside the blood is strictly regulated by homeostatic mechanisms such as stimulation of thirst, production of antidiuretic hormone (ADH) and renal engagement in excretion or preservation of sodium. All of these are considered responsible for optimal level of serum sodium concentration and maintaining desirable serum osmolarity.

Hyponatremia represents imbalance in the amount of sodium in the body. It can cause serious health issues, therefore, it needs to be diagnosed and treated on time.

Types of Hyponatremia

Hypovolemic hyponatremia develops due to total decrease in body volume. This leads to decrease in extracellular fluid volume and total body natrium.

Euvolemic hyponatremia develops when total body volume remains normal and there is minimal/moderate increase in extracellular fluid volume. Such condition may cause slight swelling.

In hypervolemic hyponatremia both, total body volume as well extracellular fluid volume increase significantly which consequently leads to edema.

In redistribution hyponatremia fluid stays inside of the cells filling the extracellular compartment which results in dilution of sodium. It is a common consequence after a person has been administered mannitol due to hyperglycemia. In such case total body volume and total body sodium remain unchanged.

And finally, there is pseudohyponatremia, a condition in which the aqueous phase gets diluted by the presence of too much proteins and lipids. Similarly to the previous type, total body volume and total body sodium are practically intact. Pseudohyponatremia is common for patients suffering from hypertriglyceridemia and multiple myeloma.

What Causes Hyponatremia?

There are many different causes of hyponatremia. For example, the problem is commonly associated with burns, congestive heart failure and diarrhea. Furthermore, it can develop as a consequence of intake of some medications such as diuretics or it results from kidney disease, liver cirrhosis and syndrome of inappropriate antidiuretic hormone secretion. Uncontrollable sweating and vomiting are two more potential causes of hyponatremia.

Clinical Characteristics of Hyponatremia

This electrolyte imbalance leads to abnormal mental status accompanied by confusion, decreased consciousness, hallucinations and, if not treated on time, patients may even end up in a coma. Convulsions, fatigue, headache, restlessness and irritability as well as loss of appetite, muscle weakness or spasms/cramps, nausea and vomiting are several more non-specific symptoms and signs of hyponatremia which may, apart from this condition, occur in other illnesses as well.

Treatment for Hyponatremia

After diagnosing hyponatremia (easily achieved with blood tests) the doctor tries to identify the underlying cause and then starts the treatment. By treating the underlying cause hyponatremia can be soon brought under control. Specific treatments may include intravenous fluids or restriction of water consumption.

Rapid development of hyponatremia may cause more serious damage than gradual hyponatremia. Because in such case (chronic hyponatremia) the brain has enough time to adapt and adjust, subsequent swelling is not so intensive. However, acute hyponatremia, particularly if not treated on time, may result in brain herniation, coma or even death.

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