4.6 Review

Acute and Chronic Hyponatremia

Journal

FRONTIERS IN MEDICINE
Volume 8, Issue -, Pages -

Publisher

FRONTIERS MEDIA SA
DOI: 10.3389/fmed.2021.693738

Keywords

hyponatremia; osmolyte; syndrome of inappropriate antidiuresis; overcorrection; myelinolysis; central pontine

Funding

  1. National Institutes of Health [HL109015, HL071556, HL105649]

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Hyponatremia is a common electrolyte disorder in clinical practice, and proper treatment requires understanding of the patient's hypotonic state and cerebral defense mechanisms, differentiation and management based on urine analysis, electrolytes, and volume status.
Hyponatremia is the most common electrolyte disorder in clinical practice. Catastrophic complications can occur from severe acute hyponatremia and from inappropriate management of acute and chronic hyponatremia. It is essential to define the hypotonic state associated with hyponatremia in order to plan therapy. Understanding cerebral defense mechanisms to hyponatremia are key factors to its manifestations and classification and subsequently to its management. Hypotonic hyponatremia is differentiated on the basis of urine osmolality, urine electrolytes and volume status and its treatment is decided based on chronicity and the presence or absence of central nervous (CNS) symptoms. Proper knowledge of sodium and water homeostasis is essential in individualizing therapeutic plans and avoid iatrogenic complications while managing this disorder.

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