Clinical Profile and Laboratory Spectrum of Hyponatremia in Patients Admitted In Tertiary Care Hospital.
Journal Title: International Journal of Medical Science and Innovative Research (IJMSIR) - Year 2019, Vol 4, Issue 3
Abstract
Background and Objectives Hyponatremia is a common electrolyte disorder in adults. The underlying cause in them is often multi-factorial, a clear history may be difficult to obtain and clinical examination is unreliable. Established treatment modalities are often ineffective and carry considerable risks, especially if the diagnosis of underlying causes is incorrect which requires prompt diagnosis and effective therapy. Data regarding the incidence of hyponatremia in elderly in our country is limited. This study is done to know the common clinical features and etiology of hyponatremia in adults in hospitalized patients and to manage such patients. Objectives 1. To study the clinical features of hyponatremia in adults. 2. To identify and assess the risk factors of hyponatremia in adults. 3. Management of hyponatremia. Methods A descriptive study was conducted in a tertiary care hospital (SSMC, Tumkur) during the period of November 2016 to October 2018. Patients aged ≥ 18 years admitted with serum sodium < 135 mEq/L were included in the study. 107 patients were selected randomly. These patients were evaluated for the underlying cause for hyponatremia by a detailed history and physical examination and followed by appropriate lab investigations. Results 107 patients were included in the study. 64.5% had presented with constitutional symptoms, 52.3% had confusion, 50.5% had other symptoms, 49.5% had fever, 41.1% had vomiting, 37.4% had respiratory symptoms, 36.4% had pain abdomen, 15% had loose stools, 4.7% were in coma, and 2.8% had convulsions. There was wide range of etiologies, most common being SIADH (32.7%), extra renal losses (22.4%), renal failure (13.1%), renal losses (12.1%), cirrhosis (11.2%), cardiac failure (4.7%), drug induced (2.8%) and glucocorticoid deficiency (0.9%). Hypertonic saline was given to 43%, diuretics and fluid restriction was advised for 30.8%, 20.6% were given both hypertonic saline and vaptans and 5.6% were given only vaptans. Conclusion Hyponatremia is the most common electrolyte disorder in hospitalised patients particularly in adults. A systematic approach to the diagnosis of hyponatremia with the application of simple diagnostic algorithms, using history, clinical examination and laboratory findings to establish mechanism of hyponatremia can significantly improve the management and outcome of hyponatremia.
Authors and Affiliations
Dr. Shahbaz Baig C. M.
Keywords
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