Why fluid restriction for low sodium

The cause of low sodium must be diagnosed and treated. If cancer is the cause of the condition, then radiation, chemotherapy , or surgery to remove the tumor may correct the sodium imbalance.

Outcome depends on the condition that is causing the problem. Low sodium that occurs in less than 48 hours acute hyponatremia , is more dangerous than low sodium that develops slowly over time. When sodium level falls slowly over days or weeks chronic hyponatremia , the brain cells have time to adjust and swelling may be minimal. Call your provider right away if you have symptoms of this condition. If you play sports or do other vigorous activity, drink fluids such as sports drinks that contain electrolytes to keep your body's sodium level in a healthy range.

Hyponatremia; Dilutional hyponatremia; Euvolemic hyponatremia; Hypervolemic hyponatremia; Hypovolemic hyponatremia. Hyponatremia and hypernatremia. Endocrinology: Adult and Pediatric. Philadelphia, PA: Elsevier Saunders; chap Little M. Metabolic emergencies. Textbook of Adult Emergency Medicine. Some causes, such as congestive heart failure or use of diuretics, are obvious.

Other causes, such as SIADH and endocrine deficiencies, usually require further evaluation before identification and appropriate treatment. The initial rate of sodium correction with hypertonic saline should not exceed 1 to 2 mmol per L per hour. Overzealous correction of chronic hyponatremia can lead to central pontine myelinolysis. Demeclocycline Declomycin in a dosage of to 1, mg daily is effective in patients with refractory hyponatremia. Arginine vasopressin receptor antagonists may be useful in patients with chronic hyponatremia.

Already a member or subscriber? Log in. Interested in AAFP membership? Learn more. Address correspondence to Kian Peng Goh, M. Reprints are not available from the author. The author indicates that he does not have any conflicts of interest. Sources of funding: none reported. The author thanks Evelyn Koay, S. Incidence and etiology of hyponatremia in an intensive care unit.

Clin Nephrol. Hyponatremia as observed in a chronic disease facility. J Am Geriatr Soc. Kumar S, Berl T. Hyponatremia in a nursing home population. Arieff AI.

Hyponatremia, convulsions, respiratory arrest, and permanent brain damage after elective surgery in healthy women. N Engl J Med. Hyponatraemia and death or permanent brain damage in healthy children. Postoperative hyponatremic encephalopathy in menstruant women.

Ann Intern Med. Hyponatremia in the emergency department. Am J Emerg Med. Neurologic sequelae after treatment of severe hyponatremia: a multi-center perspective. J Am Soc Nephrol. Osmotic demyelination syndrome following correction of hyponatremia. Cases in chemical pathology: a diagnostic approach.

Singapore: World Scientific, Predictors of outcome in hospitalized patients with severe hyponatremia. J Natl Med Assoc. A primer of chemical pathology. The rational clinical examination. Is this patient hypovolemic?.

Physician misdiagnosis of dehydration in older adults. J Am Med Dir Assoc. Agarwal R, Emmett M. The post-transurethral resection of prostate syndrome: therapeutic proposals. Am J Kidney Dis. Hyponatremic-hypertensive syndrome with renal ischemia: an underrecognized disorder. The hyponatremic patient: a systematic approach to laboratory diagnosis. Janicic N, Verbalis JG. Evaluation and management of hypoosmolality in hospitalized patients.

Endocrinol Metab Clin North Am. Spital A. Diuretic-induced hyponatremia. Am J Nephrol. Chan TY. Drug-induced syndrome of inappropriate antidiuretic hormone secretion. Causes, diagnosis and management. Drugs Aging. Hyponatraemia and hypokalaemia due to indapamide. Med J Aust. Incidence and risk factors for hyponatraemia following treatment with fluoxetine or paroxetine in elderly people.

Br J Clin Pharmacol. SIADH and hyponatremia with theophylline. Ann Pharmacother. Syndrome of inappropriate antidiuretic hormone-induced hyponatremia associated with amiodarone. Lecture notes on clinical biochemistry. Oxford: Blackwell Science, Beck LH.

Hypouricemia in the syndrome of inappropriate secretion of antidiuretic hormone. Ectopic production and processing of atrial natriuretic peptide in a small cell lung carcinoma cell line and tumor from a patient with hyponatremia.

Neurological manifestations and morbidity of hyponatremia: correlation with brain water and electrolytes. Medicine [Baltimore]. Treatment of symptomatic hyponatremia and its relation to brain damage. A prospective study. Gross P. Arch Orthop Trauma Surg. Korkmaz I, et al. Baseline characteristics and the association between hyponatraemia and pulmonary embolism prognosis. J Pak Med Assoc. Assadi F. Hyponatremia: a problem-solving approach to clinical cases.

J Nephrol. Verbalis JG, et al. Diagnosis, evaluation, and treatment of hyponatremia: expert panel recommendations. Spasovski G, et al. Clinical practice guideline on diagnosis and treatment of hyponatraemia. Eur J Endocrinol. Masri G, et al. Evaluation of hyponatremia. Accessed October 8, Sarikonda KV, et al. Imbriano LJ, et al. Normal fractional urate excretion identifies hyponatremic patients with reset osmostat.

Carvounis CP, et al. Significance of the fractional excretion of urea in the differential diagnosis of acute renal failure. Albert NM, et al.

A randomized controlled pilot study of outcomes of strict allowance of fluid therapy in hyponatremic heart failure SALT-HF. J Card Fail. Sterns RH, et al. The treatment of hyponatremia. Semin Nephrol. Sood L, et al. Hypertonic saline and desmopressin: a simple strategy for safe correction of severe hyponatremia. Hew-Butler T, et al. Clin J Sport Med.

Moritz ML, et al. Metab Brain Dis. Tolvaptan, an oral vasopressin antagonist, in the treatment of hyponatremia in cirrhosis. J Hepatol. Hauptman PJ, et al. Clinical course of patients with hyponatremia and decompensated systolic heart failure and the effect of vasopressin receptor antagonism with tolvaptan.

Schrier RW, et al. Tolvaptan, a selective oral vasopressin V2-receptor antagonist, for hyponatremia. Josiassen RC, et al. Vaptans: a potential new approach for treating chronic hyponatremia in psychotic patients.

Clin Schizophr Relat Psychoses. Oral tolvaptan is safe and effective in chronic hyponatremia [published correction appears in J Am Soc Nephrol. J Am Soc Nephrol. Dahl E, et al. Mc Causland FR, et al. Association of serum sodium with morbidity and mortality in hospitalized patients undergoing major orthopedic surgery.

J Hosp Med. Leung AA, et al. Preoperative hypernatremia predicts increased perioperative morbidity and mortality. Funder JW, et al. Case detection, diagnosis, and treatment of patients with primary aldosteronism: an Endocrine Society clinical practice guideline. Sands JM, et al. Nephrogenic diabetes insipidus. Ann Intern Med. Reynolds RM, et al. Disorders of sodium balance. Kahn A, et al. Controlled fall in natremia and risk of seizures in hypertonic dehydration.

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Contact afpserv aafp. Want to use this article elsewhere? Get Permissions. Read the Issue. Sign Up Now. Next: Evaluation and Treatment of Infertility. Mar 1, Issue. Author disclosure: No relevant financial affiliations. C 13 , 14 Consensus guidelines based on small studies Vaptans appear to be safe for the treatment of severe hypervolemic and euvolemic hyponatremia but should not be used routinely.

C 14 Consensus guidelines based on observational studies Chronic hypernatremia should be corrected at a rate of 0. Enlarge Print Evaluation of Hyponatremia Figure 1. Algorithm for the evaluation of hyponatremia Information from references 11 through Evaluation of Hyponatremia Figure 1.

Enlarge Print Table 1. Table 1. Enlarge Print eTable A. Algorithm for the treatment of severe symptomatic hyponatremia. Treatment of Severe Symptomatic Hyponatremia Figure 2. Enlarge Print eTable B. Enlarge Print Table 2. Table 2. Enlarge Print Evaluation of Hypernatremia Figure 3. Algorithm for the evaluation of hypernatremia. Evaluation of Hypernatremia Figure 3. Enlarge Print eTable C. Read the full article. Get immediate access, anytime, anywhere. Choose a single article, issue, or full-access subscription.

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Consensus guidelines based on systematic reviews. Consensus guidelines based on small studies. Consensus guidelines based on observational studies.

Hyperglycemia e. Insulin, intravenous fluids, isotonic saline. Elevated total and low-density lipoprotein cholesterol levels. Hyperproteinemia e. Hypovolemic hyponatremia. Cerebral salt wasting. Isotonic or hypertonic saline. Stop diuretic therapy. Gastrointestinal loss e. Steroid replacement therapy. Elevated glucose level, mannitol use. Correct glucose level, stop mannitol use.

Renal tubular acidosis. Correct acidosis, sodium bicarbonate. Salt-wasting nephropathies. Correct underlying cause.