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Category: Volume 06 Issue 10 October 2018
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Title: Profile of Hyponatremia in Patients admitted into Medical ICU

Authors: Dr P Sharmas Vali, Dr Kiranmai Ismal, Dr Manisha Sahay

 DOI: https://dx.doi.org/10.18535/jmscr/v6i10.194

Abstract

Background: Hyponatremia is a common metabolic disorder in all subsets of patients including critically ill medical patients. Hyponatremia is caused by a diverse set of causes and evaluation at times can be challenging. The symptomatology of Hyponatremia is a spectrum and at times patients can be asymptomatic. The symptomatology depends on the rapidity of the onset of Hyponatremia and symptoms are decided by the rapidity of Astrocyte adaptation to decreasing serum tonicity.

Methods: This retrospective study which included patients admitted into Medical Intensive care Unit (ICU) between September 2016 to August 2018 is aimed at the analysis of hyponatremia admitted into Medical ICU. This study is based on the evaluation of etiology based on standard clinical and laboratory tools and focusses on the clinical and laboratory profiles of patients with Hyponatremia in Medical ICU.

Results: A total of 142 patients with Hyponatremia were identified. There was a male preponderance with males constituting 62 % of the study population. The mean age of the study population was 54.8 +/- 12.8. Hyponatremia was acute in 42.2 % of patients (60 patients) while it is chronic in 57.8 %. Vomiting was the most common manifestation was reported in 57 % of patients while altered Sensorium and Seizures were documented in 29.5 % and 12 % of patients. Euvolemia, Hypovolemia and Hypervolemia was noted in 46%, 33% and 21 % of patients. Syndrome of Inappropriate Anti Diuretic Hormone Secretion (SIADH) is the most common form of euvolemic hyponatremia and it accounted for 91 % of cases of Euvolemic Hyponatremia. Thiazide induced hyponatremia was noted in 18.3% of the total study population and was the most common type of Hypovolemic Hyponatremia. The therapy correct Hyponatremia was well tolerated and none had Osmotic Demyelination Syndrome (ODS). 18 patients died during their hospital stay (12.6 %). 

Conclusions: The most common form of Hyponatremia is Euvolemic pattern of Hyponatremia. SIADH is the major type of euvolemic hyponatremia. Thiazides induced hyponatremia is noted in 18.3 % of total patients and is the most common form of Hypovolemic Hyponatremia. None of the patients experienced ODS. Mortality was recorded in 12.6 % of study population.

Keywords: Hyponatremia, Syndrome of Inappropriate Anti Diuretic Hormone Secretion (SIADH), Thiazide induced Hyponatremia, Osmotic Demyelination Syndrome (ODS).

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Corresponding Author

Dr P Sharmas Vali

Associate Professor, Dept of Nephrology, Osmania General Hospital, Hyderabad-35, Telangana, India

Email: This email address is being protected from spambots. You need JavaScript enabled to view it., Mob: 9397399953