Endocrine Abstracts

Introduction: Hyponatraemia is the commonest electrolyte disorder in clinical practice and is closely associated with increased morbidity, mortality and length of hospital stay. It can be classified into mild (124–134 mmol/l), moderate (115–124 mmol/l), and severe (<115 mmol/l). The aim of the study was to determine the prevalence, aetiology, and management of hyponatraemia in general hospital.

Methods: A total of 4139 acute medical admissions were studied. Hyponatraemia was found in 536 patients with 441 being mild, 86 moderate and nine severe; 130 cases were analysed further in details.

Results: Out of 130 cases; 86 were of mild (66%), 42 moderate (32%), and one severe hyponatraemia (0.8%). The mean age was 75.1 years (17–99) and there is equal male to female ratio. The cause of hyponatraemia was only identified in 68% with diuretics accounting for 41 (46%), Syndrome of Inappropriate ADH Secretion (SIADH) for 36 (40%) and fluid overload for 12 (9%) of cases. The treatment of hyponatraemia included intravenous fluid resuscitation in 52, cessation of diuretics in 43 and fluid restriction in 48 of cases. One subject with severe hyponatraemia received demeclocycline, none of the subjects received hypertonic saline or Vasopressin receptor antagonist. While the average length of stay for all medical admissions was 4 days, the average length of stay is 17.1 days (2–70) in those with hyponatraemia.

Conclusion: Hyponatraemia, which presents in 12.9% of our admissions, is associated with significantly prolonged hospital length of stay. The use of diuretics and SIADH were the main cause of hyponatraemia in our cohort. Our study highlighted the challenge in the diagnosis as evidenced by 32% of patients in whom diagnosis was not reached. A trust guideline has been developed as a response to this issue.