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Electrolyte Imbalance


Overview, Hyponatremia

Physician developed and monitored.

Original Date of Publication: 01 May 2001
Reviewed by: Stanley J. Swierzewski, III, M.D.

Original Source: http://www.nephrologychannel.com/electrolytes/index.shtml

Home » Electrolyte Imbalance » Overview, Hyponatremia

Overview



Electrolytes are salts that conduct electricity and are found in the body fluid, tissue, and blood. Examples are chloride, calcium, magnesium, sodium, and potassium. Sodium (Na+) is concentrated in the extracellular fluid (ECF) and potassium (K+) is concentrated in the intracellular fluid (ICF). Proper balance is essential for muscle coordination, heart function, fluid absorption and excretion, nerve function, and concentration.

The kidneys regulate fluid absorption and excretion and maintain a narrow range of electrolyte fluctuation. Normally, sodium and potassium are filtered and excreted in the urine and feces according to the body's needs. Too much or too little sodium or potassium, caused by poor diet, dehydration, medication, and disease, results in an imbalance. Too much sodium is called hypernatremia; too little is called hyponatremia. Too much potassium is called hyperkalemia; too little is called hypokalemia.

Incidence and Prevalence
Hyponatremia is the most common electrolyte imbalance. It is associated with kidney disease such as nephrotic syndrome and acute renal failure (ARF). Men and women with healthy kidneys have equal chances of experiencing electrolyte imbalance, and people with eating disorders such as anorexia and bulimia, which most often affect women, are at increased risk. Very young people and old people are affected more often than young adults.

Hyponatremia

Causes
Hyponatremia is caused by conditions such as water retention and renal failure that result in a low sodium level in the blood.

Pseudohyponatremia occurs when too much water is drawn into the blood; it is commonly seen in people with hypoglycemia (low blood sugar).

Psychogenic polydipsia occurs in people who compulsively drink more than four gallons of water a day.

Hypovolemic hyponatremia (with low blood volume due to fluid loss) occurs in dehydrated people who rehydrate (drink a lot of water) too quickly, in patients taking thiazide diuretics, and after severe vomiting or diarrhea.



Hypervolemic hyponatremia (high blood volume due to fluid retention) occurs in people with live cirrhosis, heart disease, or nephrotic syndrome. Edema (swelling) often develops with fluid retention.

Euvolemic hyponatremia (decrease in total body water) occurs in people with hypothyroidism, adrenal gland disorder, and disorders that increase the release of the antidiuretic hormone (ADH), such as tuberculosis, pneumonia, and brain trauma.

Signs and Symptoms
Symptoms of hyponatremia are related to the severity and the rate at which the conditions develop. The first symptoms are fatigue, weakness, nausea, and headache. More severe cases cause confusion, seizure, coma, and death.

Treatment
The goal of treatment is to restore electrolyte balance for proper hydration and use of total body fluid. Sodium deficiency must be corrected slowly because drastic change in sodium level can cause brain cell shrinkage and central pontine myelinolysis (damage to the pons region of the brain). Methods include:

  • Fluid and water restriction
  • Intravenous (IV) saline solution of 3% sodium
  • Salt tablets

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