Hyponatremia laboratory findings: Difference between revisions
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==Overview== | ==Overview== | ||
In hyponatremia, depending on the cause, there can be different laboratory abnormalities. | |||
To see the causes of hyponatremia, click [[Hyponatremia causes#Causes|here]]. | |||
To see the differential diagnosis of hyponatremia, click [[Hyponatremia differential diagnosis#Differentiating etiologies of Hyponatremia|here]]. | |||
==Laboratory Findings== | |||
'''Biochemical evaluation for finding the etiologies of hyponatremia :''' | |||
*CT scan for brain chest abdomen and pelvis is necessary for patients to evaluate the causes like SIAD( tumor detection ), and differentiate from other causes with the same presentation. | |||
[ | For different causes of hyponatremia, click [[Hyponatremia causes#Causes|here]]. | ||
For approach to differential diagnosis, click [[Hyponatremia differential diagnosis#Differentiating etiologies of Hyponatremia|here]]. | |||
For the clinical approach to diagnosis, click [[Hyponatremia diagnostic study of choice#Diagnostic Approach to Hyponatremia|here]]. | |||
<br>'''Laboratory findings in different causes of hyponatremia '''<ref>{{Cite journal | |||
| author = [[Wiebke Fenske]], [[Sebastian K. G. Maier]], [[Anne Blechschmidt]], [[Bruno Allolio]] & [[Stefan Stork]] | |||
= | | title = Utility and limitations of the traditional diagnostic approach to hyponatremia: a diagnostic study | ||
| journal = [[The American journal of medicine]] | |||
| volume = 123 | |||
| issue = 7 | |||
| pages = 652–657 | |||
| year = 2010 | |||
| month = July | |||
| doi = 10.1016/j.amjmed.2010.01.013 | |||
| pmid = 20609688 | |||
< | }}</ref>''':''' | ||
<small> | |||
{| class="wikitable" | {| class="wikitable" | ||
!Conditions | !Conditions | ||
| Line 69: | Line 59: | ||
|> 100 mOsm/kg | |> 100 mOsm/kg | ||
|'''U<sub>Na</sub> > 20 mEq/L:''' | |'''U<sub>Na</sub> > 20 mEq/L:''' | ||
* Acute or chronic renal failure | *Acute or chronic [[renal failure]] | ||
*Fluid overload | |||
*[[Psychogenic polydipsia]] | |||
*[[Diuretic]] use in: [[Heart failure]] [[Liver disease|, Liver disease]], [[Nephrotic syndrome]] | |||
'''U<sub>Na</sub> < 20 mEq/L:''' | '''U<sub>Na</sub> < 20 mEq/L:''' | ||
* Cirrhosis | *[[Heart failure]] | ||
*[[Primary polydipsia]] | |||
*[[Cirrhosis]] | |||
* Nephritic/nephrotic syndrome | *Nephritic/[[nephrotic syndrome]] | ||
|- | |- | ||
!Euvolemic hyponatremia | !<big>Euvolemic hyponatremia</big> | ||
|TBW ↑ | |TBW ↑ | ||
Serum Na ↔ | Serum Na ↔ | ||
| Line 87: | Line 80: | ||
|> 100 mOsm/kg | |> 100 mOsm/kg | ||
|'''Variable U<sub>Na</sub>''' ''':''' | |'''Variable U<sub>Na</sub>''' ''':''' | ||
* SIAD/ SIADH | *[[SIADH|SIAD]]/ SIADH with fluid restriction | ||
*[[Hypothyroidism]] | |||
'''U<sub>Na</sub> > 40 mEq/L:''' | '''U<sub>Na</sub> > 40 mEq/L:''' | ||
* Hypothyroidism | *[[Cortisol]] deficiency | ||
* Drugs | *[[ACTH]] deficiency | ||
* SIAD/ SIADH | |||
*[[Hypothyroidism]] | |||
*Drugs | |||
*[[SIADH|SIAD]]/ SIADH | |||
|- | |- | ||
!Hypovolemic hyponatremia | !<big>Hypovolemic hyponatremia</big> | ||
|TBW ↔ | |TBW ↔ | ||
Serum Na ↓↓ | Serum Na ↓↓ | ||
| Line 101: | Line 98: | ||
|> 500 mOsm/kg | |> 500 mOsm/kg | ||
|'''U<sub>Na</sub> > 30 mEq/L:''' | |'''U<sub>Na</sub> > 30 mEq/L:''' | ||
* Renal loss: | *Renal loss: | ||
** [[Osmotic diuresis]] ([[glucose]], [[urea]], bicarbonaturia) | **[[Osmotic diuresis]] ([[glucose]], [[urea]], bicarbonaturia) | ||
** Salt-Iosing nephropathy | **[[Salt-Iosing nephropathy]] | ||
** [[Addison disease]] | **[[Addison disease]] | ||
** [[Cerebral salt wasting syndrome|CSW]] | **[[Cerebral salt wasting syndrome|CSW]] | ||
** Diuretics | **[[Diuretics]] | ||
'''U<sub>Na</sub> < 30 mEq/L:''' | '''U<sub>Na</sub> < 30 mEq/L:''' | ||
* Extra renal loss: | *[[Diuretics]] | ||
** [[Vomiting]] (U<sub>cl</sub> ↓) | |||
** [[Diarrhea]] | *Extra renal loss: | ||
** [[Pancreatitis]] | **[[Vomiting]] (U<sub>cl</sub> ↓) | ||
** [[Sweating]] | **[[Diarrhea]] | ||
** Small bowel obstruction | **[[Pancreatitis]] | ||
**[[Sweating]] | |||
**[[Small bowel obstruction]] | |||
|} | |} | ||
</small> | |||
==References== | ==References== | ||
Latest revision as of 20:26, 2 July 2021
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Hyponatremia Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Hyponatremia laboratory findings On the Web |
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American Roentgen Ray Society Images of Hyponatremia laboratory findings |
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Risk calculators and risk factors for Hyponatremia laboratory findings |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Saeedeh Kowsarnia M.D.[2]
Overview
In hyponatremia, depending on the cause, there can be different laboratory abnormalities.
To see the causes of hyponatremia, click here.
To see the differential diagnosis of hyponatremia, click here.
Laboratory Findings
Biochemical evaluation for finding the etiologies of hyponatremia :
- CT scan for brain chest abdomen and pelvis is necessary for patients to evaluate the causes like SIAD( tumor detection ), and differentiate from other causes with the same presentation.
For different causes of hyponatremia, click here.
For approach to differential diagnosis, click here.
For the clinical approach to diagnosis, click here.
Laboratory findings in different causes of hyponatremia [1]:
| Conditions | Sodium status | Plasma osmolality | Urine osmolality | Differentiation of causes |
|---|---|---|---|---|
| Hypervolemic hyponatremia | TBW ↑↑
Serum Na ↑ |
< 275 mOsm/kg | > 100 mOsm/kg | UNa > 20 mEq/L:
UNa < 20 mEq/L:
|
| Euvolemic hyponatremia | TBW ↑
Serum Na ↔ |
< 275 mOsm/kg | > 100 mOsm/kg | Variable UNa :
UNa > 40 mEq/L:
|
| Hypovolemic hyponatremia | TBW ↔
Serum Na ↓↓ |
< 275 mOsm/kg | > 500 mOsm/kg | UNa > 30 mEq/L:
UNa < 30 mEq/L:
|
References
- ↑ Wiebke Fenske, Sebastian K. G. Maier, Anne Blechschmidt, Bruno Allolio & Stefan Stork (2010). "Utility and limitations of the traditional diagnostic approach to hyponatremia: a diagnostic study". The American journal of medicine. 123 (7): 652–657. doi:10.1016/j.amjmed.2010.01.013. PMID 20609688. Unknown parameter
|month=ignored (help)