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Thursday, June 02, 2016

More thoughts on correction of severe hyponatremia

In adults electrolyte issues have traditionally been the arena in which internists ( and I guess now mainly hospitalists) earn their fees. Here is an interesting take on the correction of severe hyponatremia.

Severe ( often defined as less than 120) hyponatremia is typically considered as an medical emergency. Discussions regarding it usually consider acute hyponatremia ( as in runner's hyponatremia) and chronic. In the former some urgency exists in regard to treatment as the concern is brain swelling and catastrophic brain herniation. In chronic, too rapid correction runs the risk of osmotic demyelination.

Beer potomania is part of the differential diagnosis of hyponatremia. This article provides gives data on alcoholic patients with hyponatremia and explains several mechanisms for the low sodium other than what is usually thought to occur in beer potomania syndrome.


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