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==Overview==
==Overview==
Hyponatremia is the most common electrolyte disorder. Its frequency is higher in females, the elderly, and in patients who are hospitalized. The incidence of hyponatremia depends largely on the patient population. A hospital incidence of 15–20% is common, while only 3–5% of patients who are hospitalized have a serum sodium level of less than 130 mEq/L. Hyponatremia has been reported in up to 30% of elderly patients in nursing homes and is also present in approximately 30% of depressed patients on [[selective serotonin reuptake inhibitor]]s.<ref name="autogenerated185">Schrier, Robert W. "Does 'asymptomatic hyponatremia' exist?" Nature Reviews Nephrology. Vol 6, Apr 2010; p 185.</ref>
Hyponatremia is the most common electrolyte disorder. Its frequency is higher in females, elderly, and the patients who are hospitalized. The incidence of hyponatremia depends largely on the patient population which is a dependent of the underlying cause. A hospital incidence of 15–30% is common. Age over 30, female gender and lower body weights are risk factors for developing complications associated with hyponatremia.


==Epidemiology and Demographics ==
==Epidemiology and Demographics ==
===Incidence===
===Incidence===
* Hyponatremia is the most common electrolyte disturbances encountered in clinical practice, occurring in 15%-30% of acutely or chronically hospitalized patients <ref name="UpadhyayJaber20062">{{cite journal|last2=Jaber|first2=Bertrand L.|last3=Madias|first3=Nicolaos E.|year=2006|title=Incidence and Prevalence of Hyponatremia|journal=The American Journal of Medicine|volume=119|issue=7|pages=S30–S35|doi=10.1016/j.amjmed.2006.05.005|issn=00029343|last1=Upadhyay|first1=Ashish}}</ref> and 7.7 % of cases in outpatients clinics.
* Hyponatremia is the most common [[electrolyte disturbances]] in clinical practice, occurring in 15%-30% of hospitalized patients ( acutely or chronically) <ref name="UpadhyayJaber20062">{{cite journal|last2=Jaber|first2=Bertrand L.|last3=Madias|first3=Nicolaos E.|year=2006|title=Incidence and Prevalence of Hyponatremia|journal=The American Journal of Medicine|volume=119|issue=7|pages=S30–S35|doi=10.1016/j.amjmed.2006.05.005|issn=00029343|last1=Upadhyay|first1=Ashish}}</ref>, 1-2% of this patients present with severe hyponatremia (serum sodium < 125 mEq/L)  .
.  
* Post-operative hyponatremia develops in 4.4%  of patients within 1st week of surgery <ref name="UpadhyayJaber2006">{{cite journal|last1=Upadhyay|first1=Ashish|last2=Jaber|first2=Bertrand L.|last3=Madias|first3=Nicolaos E.|title=Incidence and Prevalence of Hyponatremia|journal=The American Journal of Medicine|volume=119|issue=7|year=2006|pages=S30–S35|issn=00029343|doi=10.1016/j.amjmed.2006.05.005}}</ref> .
 
*The incidence/prevalence of [disease name] is approximately [number range] per 100,000 individuals worldwide.
*In [year], the incidence/prevalence of [disease name] was estimated to be [number range] cases per 100,000 individuals worldwide.


===Prevalence===
===Prevalence===
* Hyponatremia  is seen in up to 27% of patients with heart failure (HF) <ref name="BettariFiuzat20122">{{cite journal|last2=Fiuzat|first2=Mona|last3=Shaw|first3=Linda K.|last4=Wojdyla|first4=Daniel M.|last5=Metra|first5=Marco|last6=Felker|first6=G. Michael|last7=O’Connor|first7=Christopher M.|year=2012|title=Hyponatremia and Long-Term Outcomes in Chronic Heart Failure—An Observational Study From the Duke Databank for Cardiovascular Diseases|journal=Journal of Cardiac Failure|volume=18|issue=1|pages=74–81|doi=10.1016/j.cardfail.2011.09.005|issn=10719164|last1=Bettari|first1=Luca}}</ref>
* Prevalence of hyponatremia is 1720 per 100,000 in the U.S. population <ref name="MohanGu2013">{{cite journal|last1=Mohan|first1=Sumit|last2=Gu|first2=Sue|last3=Parikh|first3=Amay|last4=Radhakrishnan|first4=Jai|title=Prevalence of Hyponatremia and Association with Mortality: Results from NHANES|journal=The American Journal of Medicine|volume=126|issue=12|year=2013|pages=1127–1137.e1|issn=00029343|doi=10.1016/j.amjmed.2013.07.021}}</ref> .
* and up to 50% of patients with cirrhosis and ascites are found to be hyponatremic <ref name="AngeliWong20062">{{cite journal|last2=Wong|first2=Florence|last3=Watson|first3=Hugh|last4=Ginès|first4=Pere|year=2006|title=Hyponatremia in cirrhosis: Results of a patient population survey|journal=Hepatology|volume=44|issue=6|pages=1535–1542|doi=10.1002/hep.21412|issn=02709139|last1=Angeli|first1=Paolo}}</ref>
* Nearly 7.7 % of patients who are visited in outpatients clinics are hyponatremic.
*The incidence/prevalence of [disease name] is approximately [number range] per 100,000 individuals worldwide.
* Hyponatremia  is seen in up to 27% of patients with heart failure (HF) <ref name="BettariFiuzat20122">{{cite journal|last2=Fiuzat|first2=Mona|last3=Shaw|first3=Linda K.|last4=Wojdyla|first4=Daniel M.|last5=Metra|first5=Marco|last6=Felker|first6=G. Michael|last7=O’Connor|first7=Christopher M.|year=2012|title=Hyponatremia and Long-Term Outcomes in Chronic Heart Failure—An Observational Study From the Duke Databank for Cardiovascular Diseases|journal=Journal of Cardiac Failure|volume=18|issue=1|pages=74–81|doi=10.1016/j.cardfail.2011.09.005|issn=10719164|last1=Bettari|first1=Luca}}</ref> .
*In [year], the incidence/prevalence of [disease name] was estimated to be [number range] cases per 100,000 individuals worldwide.
* Approximately 50% of patients with [[cirrhosis]] and [[ascites]] are found to be hyponatremic <ref name="AngeliWong20062">{{cite journal|last2=Wong|first2=Florence|last3=Watson|first3=Hugh|last4=Ginès|first4=Pere|year=2006|title=Hyponatremia in cirrhosis: Results of a patient population survey|journal=Hepatology|volume=44|issue=6|pages=1535–1542|doi=10.1002/hep.21412|issn=02709139|last1=Angeli|first1=Paolo}}</ref> .
*The prevalence of [disease/malignancy] is estimated to be [number] cases annually.
* Hyponatremia has been reported in up to 30% of elderly patients in nursing homes and is also present in approximately 30% of depressed patients on [[selective serotonin reuptake inhibitors]] <ref name="autogenerated18522">Schrier, Robert W. "Does 'asymptomatic hyponatremia' exist?" Nature Reviews Nephrology. Vol 6, Apr 2010; p 185.</ref> .


===Case-fatality rate/Mortality rate===
===Case-fatality rate/Mortality rate===
*In [year], the incidence of [disease name] is approximately [number range] per 100,000 individuals with a case-fatality rate/mortality rate of [number range]%.
*Over the period of 1999-2006, mortality rate was 11% and 4% for hyponatremic and normonatremia subjects, respectively <ref name="MohanGu20132">{{cite journal|last1=Mohan|first1=Sumit|last2=Gu|first2=Sue|last3=Parikh|first3=Amay|last4=Radhakrishnan|first4=Jai|title=Prevalence of Hyponatremia and Association with Mortality: Results from NHANES|journal=The American Journal of Medicine|volume=126|issue=12|year=2013|pages=1127–1137.e1|issn=00029343|doi=10.1016/j.amjmed.2013.07.021}}</ref> .
*The case-fatality rate/mortality rate of [disease name] is approximately [number range].
*There is an increased risk of mortality in patients with [[congestive heart failure]], [[renal failure]] and [[cirrhosis]].
*Hyponatremia is associated with worse clinical outcome, inpatients or outpatients.
*The underlying illness that is associated with hyponatremia has more correlation with mortality rate rather than severity of hyponatremia <ref name="HoornZietse2011">{{cite journal|last1=Hoorn|first1=E. J.|last2=Zietse|first2=R.|title=Hyponatremia and Mortality: How Innocent is the Bystander?|journal=Clinical Journal of the American Society of Nephrology|volume=6|issue=5|year=2011|pages=951–953|issn=1555-9041|doi=10.2215/CJN.01210211}}</ref>.


===Age===
===Age===
*Increasing age over 30 is related to both increased rate of hyponatremia and incidence of hospital acquired hyponatremia. The association is stronger even with increasing severity of hyponatremia.
*Age over 30 is related to increased overall incident of hyponatremia especially hospital acquired hyponatremia. The association is stronger even with increasing severity of hyponatremia <ref name="UpadhyayJaber20063">{{cite journal|last1=Upadhyay|first1=Ashish|last2=Jaber|first2=Bertrand L.|last3=Madias|first3=Nicolaos E.|title=Incidence and Prevalence of Hyponatremia|journal=The American Journal of Medicine|volume=119|issue=7|year=2006|pages=S30–S35|issn=00029343|doi=10.1016/j.amjmed.2006.05.005}}</ref> .
*In elderly patients, lower body weight is associated with increased risk of drug-induced hyponatremia.
*In elderly patients, lower body weight is associated with increased risk of drug-induced hyponatremia <ref name="UpadhyayJaber20064">{{cite journal|last1=Upadhyay|first1=Ashish|last2=Jaber|first2=Bertrand L.|last3=Madias|first3=Nicolaos E.|title=Incidence and Prevalence of Hyponatremia|journal=The American Journal of Medicine|volume=119|issue=7|year=2006|pages=S30–S35|issn=00029343|doi=10.1016/j.amjmed.2006.05.005}}</ref> .
 
===Race===
*There is no racial predilection to [disease name].
===Gender===
===Gender===
*Female sex is considered a risk factor for psychotropic hyponatremia and diuretic-induced hyponatremia.
*Female sex is considered a risk factor for psychotropic and diuretic-induced hyponatremia <ref name="UpadhyayJaber20065">{{cite journal|last1=Upadhyay|first1=Ashish|last2=Jaber|first2=Bertrand L.|last3=Madias|first3=Nicolaos E.|title=Incidence and Prevalence of Hyponatremia|journal=The American Journal of Medicine|volume=119|issue=7|year=2006|pages=S30–S35|issn=00029343|doi=10.1016/j.amjmed.2006.05.005}}</ref> .
*Severe hyponatremia occurs more frequently in women because of lower body weight.
*Severe hyponatremia occurs more frequently in women because of lower body weight.
===Region===
*The majority of [disease name] cases are reported in [geographical region].
===Developed Countries===
===Developing Countries===
==References==
==References==
{{Reflist|2}}
{{Reflist|2}}

Latest revision as of 21:15, 9 August 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Saeedeh Kowsarnia M.D.[2]

Overview

Hyponatremia is the most common electrolyte disorder. Its frequency is higher in females, elderly, and the patients who are hospitalized. The incidence of hyponatremia depends largely on the patient population which is a dependent of the underlying cause. A hospital incidence of 15–30% is common. Age over 30, female gender and lower body weights are risk factors for developing complications associated with hyponatremia.

Epidemiology and Demographics

Incidence

  • Hyponatremia is the most common electrolyte disturbances in clinical practice, occurring in 15%-30% of hospitalized patients ( acutely or chronically) [1], 1-2% of this patients present with severe hyponatremia (serum sodium < 125 mEq/L) .
  • Post-operative hyponatremia develops in 4.4% of patients within 1st week of surgery [2] .

Prevalence

  • Prevalence of hyponatremia is 1720 per 100,000 in the U.S. population [3] .
  • Nearly 7.7 % of patients who are visited in outpatients clinics are hyponatremic.
  • Hyponatremia is seen in up to 27% of patients with heart failure (HF) [4] .
  • Approximately 50% of patients with cirrhosis and ascites are found to be hyponatremic [5] .
  • Hyponatremia has been reported in up to 30% of elderly patients in nursing homes and is also present in approximately 30% of depressed patients on selective serotonin reuptake inhibitors [6] .

Case-fatality rate/Mortality rate

  • Over the period of 1999-2006, mortality rate was 11% and 4% for hyponatremic and normonatremia subjects, respectively [7] .
  • There is an increased risk of mortality in patients with congestive heart failure, renal failure and cirrhosis.
  • Hyponatremia is associated with worse clinical outcome, inpatients or outpatients.
  • The underlying illness that is associated with hyponatremia has more correlation with mortality rate rather than severity of hyponatremia [8].

Age

  • Age over 30 is related to increased overall incident of hyponatremia especially hospital acquired hyponatremia. The association is stronger even with increasing severity of hyponatremia [9] .
  • In elderly patients, lower body weight is associated with increased risk of drug-induced hyponatremia [10] .

Gender

  • Female sex is considered a risk factor for psychotropic and diuretic-induced hyponatremia [11] .
  • Severe hyponatremia occurs more frequently in women because of lower body weight.

References

  1. ↑ Upadhyay, Ashish; Jaber, Bertrand L.; Madias, Nicolaos E. (2006). "Incidence and Prevalence of Hyponatremia". The American Journal of Medicine. 119 (7): S30–S35. doi:10.1016/j.amjmed.2006.05.005. ISSN 0002-9343.
  2. ↑ Upadhyay, Ashish; Jaber, Bertrand L.; Madias, Nicolaos E. (2006). "Incidence and Prevalence of Hyponatremia". The American Journal of Medicine. 119 (7): S30–S35. doi:10.1016/j.amjmed.2006.05.005. ISSN 0002-9343.
  3. ↑ Mohan, Sumit; Gu, Sue; Parikh, Amay; Radhakrishnan, Jai (2013). "Prevalence of Hyponatremia and Association with Mortality: Results from NHANES". The American Journal of Medicine. 126 (12): 1127–1137.e1. doi:10.1016/j.amjmed.2013.07.021. ISSN 0002-9343.
  4. ↑ Bettari, Luca; Fiuzat, Mona; Shaw, Linda K.; Wojdyla, Daniel M.; Metra, Marco; Felker, G. Michael; O’Connor, Christopher M. (2012). "Hyponatremia and Long-Term Outcomes in Chronic Heart Failure—An Observational Study From the Duke Databank for Cardiovascular Diseases". Journal of Cardiac Failure. 18 (1): 74–81. doi:10.1016/j.cardfail.2011.09.005. ISSN 1071-9164.
  5. ↑ Angeli, Paolo; Wong, Florence; Watson, Hugh; Ginès, Pere (2006). "Hyponatremia in cirrhosis: Results of a patient population survey". Hepatology. 44 (6): 1535–1542. doi:10.1002/hep.21412. ISSN 0270-9139.
  6. ↑ Schrier, Robert W. "Does 'asymptomatic hyponatremia' exist?" Nature Reviews Nephrology. Vol 6, Apr 2010; p 185.
  7. ↑ Mohan, Sumit; Gu, Sue; Parikh, Amay; Radhakrishnan, Jai (2013). "Prevalence of Hyponatremia and Association with Mortality: Results from NHANES". The American Journal of Medicine. 126 (12): 1127–1137.e1. doi:10.1016/j.amjmed.2013.07.021. ISSN 0002-9343.
  8. ↑ Hoorn, E. J.; Zietse, R. (2011). "Hyponatremia and Mortality: How Innocent is the Bystander?". Clinical Journal of the American Society of Nephrology. 6 (5): 951–953. doi:10.2215/CJN.01210211. ISSN 1555-9041.
  9. ↑ Upadhyay, Ashish; Jaber, Bertrand L.; Madias, Nicolaos E. (2006). "Incidence and Prevalence of Hyponatremia". The American Journal of Medicine. 119 (7): S30–S35. doi:10.1016/j.amjmed.2006.05.005. ISSN 0002-9343.
  10. ↑ Upadhyay, Ashish; Jaber, Bertrand L.; Madias, Nicolaos E. (2006). "Incidence and Prevalence of Hyponatremia". The American Journal of Medicine. 119 (7): S30–S35. doi:10.1016/j.amjmed.2006.05.005. ISSN 0002-9343.
  11. ↑ Upadhyay, Ashish; Jaber, Bertrand L.; Madias, Nicolaos E. (2006). "Incidence and Prevalence of Hyponatremia". The American Journal of Medicine. 119 (7): S30–S35. doi:10.1016/j.amjmed.2006.05.005. ISSN 0002-9343.

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