Searchable abstracts of presentations at key conferences in endocrinology
Endocrine Abstracts (2006) 12 P10

SFE2006 Poster Presentations Clinical case reports/Governance (27 abstracts)

The investigation and management of critical hyponatraemia

R Quinton , R Veeratterapillay & D Neely


Royal Victoria Infirmary, Newcastle upon Tyne Hospitals NHS Trust, Newcastle Upon Tyne, United Kingdom.


Aims

To define the prevalence of hyponatraemia (serum sodium <135 mmol/l) on our medical admissions unit and review the laboratory investigations, diagnosis and management of patients with critical or severe hyponatraemia (serum sodium <120 mmol/l).

Methods

Serum sodium levels requested from the medical admissions unit over a six-month period were retrospectively collated. Case notes and biochemistry data were reviewed for all patients with serum sodium <120 mmol/l.

Results

Serum sodium levels had been requested on a total of 3593 individual patients, among whom the prevalence of hyponatraemia was 22.2%. Thirty two (32) patients had severe hyponatraemia, of whom three died in hospital. Complete case records were obtained in 30/32 cases, among whom the major causes of hyponatraemia were diuretics (27%), carcinoma (13%) and lower respiratory tract infection (7%). However, urine sodium and serum/urine osmolalities had only been checked in 20/30 cases. There were thus inadequate data to support an accurate diagnosis in 6/30 (20%) of cases (most of them labelled with the Syndrome of Inappropriate AntiDiuretic Hormone secretion). Overall, SIADH had been diagnosed in 37% of severe hyponatraemia cases, often without adhering to recognised diagnostic criteria.

Conclusions

Severe hyponatraemia is associated with high-levels of patient morbidity and mortality. A careful assessment of drug history, clinical volume status and serum/urine biochemistry is a prerequisite for optimal management. SIADH still appears to be the ‘default’ diagnosis all too often, rather than being confirmed through the necessary clinical and biochemical criteria.

Volume 12

197th Meeting of the Society for Endocrinology

Society for Endocrinology 

Browse other volumes

Article tools

My recent searches

No recent searches.

My recently viewed abstracts