Evaluating and Managing Hyponatremia

Abstract

Although hyponatremia is a common electrolyte disorder, its evaluation and management are not well defined. When diagnosed, hyponatremia should be categorized based on four criteria: volume status, urinary Na+, serum K+, and acid-base balance. This approach helps to determine what the cause of hyponatremia is and how it should be treated. Initially, hypovolemic hyponatremia, including cerebral salt wasting syndrome (CSWS), is treated by volume resuscitation and salt supplementation. Euvolemic hyponatremia, including the syndrome of inappropriate secretion of antidiuretic hormone (SIADH), is treated by fluid restriction and salt supplementation, and hypervolemic hyponatremia is treated by fluid restriction and salt restriction. Hyponatremia can be managed well using these primary treatments and medications.

Cerebral salt wasting syndrome in craniopharyngioma

“…Other useful point in differentiating CSWS from SIADH is spot urine sodium, which is usually >100 mmol/L in the former. [9] The serum electrolyte imbalance observed in this patient was like that of SIADH. However, signs of volume depletion with urinary spot sodium 132 mmol/l distinguished the case from SIADH.…”