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Hyponatremia is the most common type of electrolyte imbalance, and is often found in older adults. [11] [12] It occurs in about 20% of those admitted to hospital and 10% of people during or after an endurance sporting event. [3] [5] Among those in hospital, hyponatremia is associated with an increased risk of death. [5]
Elderly patients may present in any of these volume states. However, "tea and toast" syndrome patients typically present euvolemic hyponatremia since their hyponatremia is caused by low solute intake. These patients must receive proper nutrition that is higher in protein and electrolyte intake. [15]
Almost a century after the pioneering work of Claude Bernard (1813–1878) in animals, Peters et al, in 1950, reported three patients seen at Yale New Haven Hospital with hyponatremia associated with varying cerebral pathologies and severe dehydration. In each patient, urine sodium losses persisted despite hyponatremia and a high-salt diet.
Hyponatremia, or low sodium, is the most commonly seen type of electrolyte imbalance. [ 12 ] [ 13 ] Treatment of electrolyte imbalance depends on the specific electrolyte involved and whether the levels are too high or too low. [ 3 ]
Hypoosmolar hyponatremia is a condition where hyponatremia is associated with a low plasma osmolality. [1] The term "hypotonic hyponatremia" is also sometimes used. [2] When the plasma osmolarity is low, the extracellular fluid volume status may be in one of three states: low volume, normal volume, or high volume.
It is a test ordered to distinguish between forms of renal failure and to classify the severity of hyponatremia. [1] The urine sodium is expressed as a concentration (such as millimoles per liter). The result must therefore be interpreted in the context of the degree of urine concentration present.
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Fractional excretion of other substances can be measured to determine kidney clearance including urea, uric acid, and lithium. These can be used in patients undergoing diuretic therapy, since diuretics induce a natriuresis. Thus, the urinary sodium concentration and FE Na may be higher in patients receiving diuretics in spite of prerenal ...