Differential diagnosis of hyponatremia and hypernatremia

Česká verzia

Authors: Otakar Pšenička; Jarmila Křížová
Authors place of work: 3. interní klinika 1. LF UK a VFN, Praha
Published in the journal: Vnitř Lék 2022; 68(E-8): 23-28
Category: Differential Diagnosis Column or What You Can Be Asked at a Postgraduate Certification Exam
doi: https://doi.org/doi.org/10.36290/vnl.2022.118

Summary

Dysnatremias are among the most common mineral imbalances encountered in clinical practice. Both hyponatremia and hypernatremia are associated with increased morbiditidy and mortality and represent negative prognostic factors regardless of their cause. Serum osmolality, extracellular fluid volume and sodium urine concentration are important parameters for evaluation the cause and differential diagnosis. The rate of onset of ionic disorder and severity of clinical symptoms are essential. While acute disorders with symptoms are treated immediately, in chronic disorders, thorough diagnostic evaluation and a careful approach to their correction are necessary. Especially with rapid substitution of chronic hyponatremia, there is a risk of osmotic demyelination syndrome. Therefore, a slow correction of the serum sodium level with frequent mineralogram checks is required.

Keywords:

hyponatremia – SIADH – hypernatremia – osmolality – osmotic demyelination syndrome

Zdroje

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