Clinical profile of patients admitted with hyponatremia in the medical intensive care unit

Abstract

Background and Aims:Hyponatremia is the predominant electrolyte abnormality with an incidence rate of approximately 22%. It is the leading cause of morbidity and mortality with scarce data in Indian intensive care settings. The aim of this study is to evaluate the clinical features and etiology of hyponatremia in patients admitted to an Intensive Care Unit (ICU) of a tertiary care hospital.Materials and Methods:A 1-year prospective cross-sectional observational study was conducted, including 100 adult patients with moderate-to-severe hyponatremia admitted to the Medical ICU. Patients underwent investigations such as serum creatinine, blood urea nitrogen, serum osmolality, serum sodium, urine sodium, and urine osmolality, sputum culture, cerebrospinal fluid analysis, and neuroimaging. Data were analyzed using independent sample t-test, Chi-square test, and Fisher's exact test.Results:Vomiting (28) followed by confusion (26) was the most common complaint. Syndrome of inappropriate antidiuretic hormone secretion (SIADH) (46) was the most common etiology for hyponatremia, and euvolemic hypoosmolar hyponatremia (50) was the most common type of hyponatremia. Confusion was significantly high in patients with severe hyponatremia as compared to patients with moderate hyponatremia (22 vs. 4, P < 0.001). In majority of the patients (46), SIADH was the main cause of euvolemic type of hyponatremia (P < 0.001). Increased urine sodium levels were observed in patients with SIADH (46), renal dysfunction (12), and drug-induced etiology (8, P < 0.001).Conclusion:Patients with hyponatremia secondary to an infectious cause should be meticulously screened for tuberculosis. The timely and effective treatment of hyponatremia is determined by the effective understanding of pathophysiology and associated risk factors of hyponatremia.

Serum electrolytes disorder and its associated factors among adults admitted with metabolic syndrome in Jimma Medical Center, South West Ethiopia: Facility based crossectional study

“…The other factor that showed significant association was taking diuretics in which the odds of developing electrolyte disorder were 4.39 higher among patients with diuretics when compared to their counterparts. This was in line with studies conducted in India, Switzerland and Ethiopia [ 38 – 40 ]. This might be dues to the fact that drugs especially diuretics are a major cause of hyponatremia in DM and hypertensive patients.…”

Syndrome of inappropriate antidiuretic hormone secretion and cerebral salt wasting as the common causes of hyponatremia in tertiary care hospital

“…14,15 Previous Indian studies have also reported similar men preponderance above 50 years of age. 6,16 In contrast, few investigations showed that women are generally affected more by hyponatremia than men (52-70%). [17][18][19] The present study revealed 39.3% of study population aged below 50 years.…”

“…They reported CNS infections, chronic liver disease and acute gastroenteritis as the common causes of hyponatremia in hospitalized patients and presented with intracranial hemorrhages as seen in this study. 6,16 Although clearly not indicative of the overall prevalence of hyponatremia globally, it has been observed in as high as 42.6% of patients in a large acute care hospital in Singapore and in 30% of patients hospitalized in an acute care setting in Rotterdam. 5,20,21 The most common cause of hyponatremia in the present study was SIADH that was in accordance with the reported studies.…”

Clinical Profile and Outcome of Patients With Hyponatremia at Tertiary Care Teaching Hospital

“…The hyponatremia group a longer stay, longer ventilator days and had more mortality Babaliche P et al [14] (2017) n=100 Prospective cross-sectional study S/S: Vomiting confusion.…”