A Conspectus of Euvolemic Hyponatremia, Its Various Etiologies, and Treatment Modalities: A Comprehensive Review of the Literature

被引:3
作者
Ghosal, Anit [1 ]
Qadeer, Hafiza Amna [2 ]
Nekkanti, Sravan K. [3 ]
Pradhan, Priyanka [3 ,5 ]
Okoye, Chiugo [4 ]
Waqar, Danish
机构
[1] Kolkata Med Coll & Hosp, Internal Med, Kolkata, India
[2] Fdn Univ Med Coll, Internal Med, Islamabad, Pakistan
[3] Davao Med Sch Fdn, Internal Med, Davao, Philippines
[4] Igbined Univ, Internal Med, Okada, Nigeria
[5] Loyola Univ Med Ctr, Internal Med Nephrol, Chicago, IL USA
关键词
diagnostic and therapeutic approach; etiology; adrenal insufficiency; syndrome of inappropriate antidiuretic hormone secretion; hyponatremia; ANTIDIURETIC-HORMONE SECRETION; EXERCISE-ASSOCIATED HYPONATREMIA; HOSPITALIZED CANCER-PATIENTS; INAPPROPRIATE SECRETION; ADRENAL INSUFFICIENCY; INTRAVENOUS IMMUNOGLOBULIN; ELECTROLYTE DISORDERS; HYPERTONIC SALINE; MANAGEMENT; DIAGNOSIS;
D O I
10.7759/cureus.43390
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Hyponatremia is the most prevalent electrolyte imbalance encountered among hospitalized patients, athletes, the elderly, patients with chronic ailments, postoperative patients, and a few asymptomatic individuals. Clinical manifestations of hyponatremia can be diverse, with characteristic neurological symptoms. Depending on in-depth medical history, physical examination (including volume status assessment), laboratory investigation, and drug history, patients can be classified broadly as undergoing hypervolemic, euvolemic, or hypovolemic hyponatremia. However, patients with hypervolemic hyponatremia often present with distinctive signs such as edema or ascites, and the clinical presentation of hypovolemic and euvolemic hyponatremia poses significant challenges for clinicians. The convolution in clinical manifestations of patients is due to the varied etiologies of euvolemic hyponatremia, such as syndrome of inappropriate antidiuretic hormone secretion (SIADH), adrenocortical insufficiency, hypothyroidism, psychogenic polydipsia, different classes of drugs (chemotherapeutics, antipsychotics, antidepressants), endurance exercise events, and reset osmostat syndrome (ROS). The management of hyponatremia depends on the rate of hyponatremia onset, duration, severity of symptoms, levels of serum sodium, and underlying comorbidities. Over the last decade, the clinical understanding of hyponatremia has been scattered due to the introduction of innovative laboratory markers and new drugs. This article will be a conspectus of all the recent advancements in the field of diagnosis, investigations, management, and associations of hyponatremia, along with traditional clinical practices. Subsequently, a holistic overview has been laid out for the clinicians to better understand and identify knowledge deficiencies on this topic.
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页数:19
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