SFEBES2026 Poster Presentations Adrenal and Cardiovascular (54 abstracts)
Clinical spectrum and aetiological distribution of profound hyponatraemia (Na <120 mmol/l) in a tertiary UK centre
Malgorzata M. Lubczynska 1 , Sarah Elshinshawy 1 , Haider Imtiaz 1 , Emma Bremner 1 , Mary Barrowcliffe 1 , Saara Abdinor 1 , Faizanur Rahman 1 , Terry Lebutt 1 , Arjun Raj 1 , Amy E. Morrison 1,2 , Shailesh Gohil 1,2 , Miles J. Levy 1,2 & Narendra Reddy 1,2
1University Hospitals of Leicester, Leicester, United Kingdom; 2University of Leicester, Leicester, United Kingdom
Background: Hyponatraemia is the most frequent electrolyte disturbance with up to 30% inpatient prevalence; often associated with significant morbidity, prolonged admission and mortality. This review aimed to identify the main aetiologies of profound hyponatraemia (Na <120 mmol/l) among inpatients at University Hospitals of Leicester (UHL) over a 1-year period.
Methods: Consecutive profound hyponatraemia cases recorded between 1st January and 31st December 2022 were reviewed retrospectively. Patients were grouped into hypovolaemic, euvolaemic and hypervolaemic categories after reviewing clinical assessment, investigations and discharge summaries at least 2 years after the initial profound hyponatraemia diagnosis; (UHL QIP No:11408).
Results: n = 250 cases. Hypovolaemic hyponatraemia 56%, Euvolaemic hyponatraemia (23%) and Hypervolaemic hyponatraemia (19%), with 2% remaining unclassified. Hypovolaemic hyponatraemia emerged as the predominant pattern & the contributing factors were dehydration, poor oral intake, infections (pneumonia, UTI etc), and diuretics (thiazide & indapamide). Smaller numbers were related to gastrointestinal losses, alcohol excess or postoperative fluid shifts. Euvolaemic hyponatraemia accounted for roughly 23% of cases, largely due to SIAD, secondary to malignancy (lung, prostate, breast and ovarian), medications including SSRIs/ TCAs (2.4%) and PPIs (4%), and endocrine disorders such as hypothyroidism (0.8%) and adrenal insufficiency (1.6%). Hypervolaemic hyponatraemia made up the remaining 19%, mainly in patients with heart failure, chronic liver disease or advanced renal impairment.
Discussion: • Hypovolaemic hyponatraemia remains the predominant presentation, reflecting the acute medical take population where infection, dehydration and diuretic use are common. The distribution is broadly similar to previous reports by Adrogué et al (NEJM, 2000) though our cohort showed a slightly higher rate of hypovolaemia: 56% vs 40%.
• Endocrine causes of profound hyponatraemia (2.4%) are in the minority, entirely reversible with hypoadrenalism being the main aetiology. • Careful intravascular volume assessment and medication review continue to be key elements in profound hyponatraemia management
Volume 117
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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