Hyponatremia causes: Difference between revisions
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==Causes== | ==Causes== | ||
===Common Causes=== | ===Common Causes=== | ||
{| class="wikitable" | |||
!Volume status | |||
!Sodium status | |||
!Causes | |||
|- | |||
|'''<big>Hypovolemic</big>''' | |||
'''<big>Hyponatremia</big>''' | |||
| | |||
* total body water ↓ | |||
* total body sodium ↓↓ | |||
| | |||
* '''GI loss:''' Vomiting, diarrhea, tube drainage | |||
* '''Insensible loss:''' Sweating, burns | |||
* '''Renal loss:''' Salt-wasting nephropathy (Inappropriate loss of Na+-Cl– in the urine), | |||
Bicarbonaturia ( Renal tubular acidosis, Metabolic alkalosis), Osmotic diuresis | |||
* '''Third spacing of fluids :''' Pancreatitis, hypoalbuminemia | |||
* '''Cerebral salt-wasting syndrome :''' Stroke ,SAH (urinary salt wasting, brain natriuretic peptide ↑) | |||
* '''Mineralocorticoid deficiency:''' Addison disease | |||
* '''Excessive diuretic administration''' | |||
|- | |||
|'''<big>Hypervolemic</big>''' | |||
'''<big>Hyponatremia</big>''' | |||
| | |||
* total body water '''↑↑''' | |||
* total body sodium ↑ | |||
| | |||
* '''Renal disease:''' Acute or chronic kidney disease or injury | |||
(due to relatively higher water versus salt intake and poor excretion),Nephrotic syndrome | |||
* '''Congestive heart failure''' | |||
* '''Cirrhosis''' | |||
* '''Iatrogenic''' | |||
|- | |||
|'''<big>Euvolemic</big>''' | |||
'''<big>Hyponatremia</big>''' | |||
| | |||
* total body water ↑ | |||
* total body sodium ↔ | |||
| | |||
* '''Drugs:'''Vasopressin, diuretics, antidepressants, opioids | |||
* '''SIADH:''' Malignancy, central nervous system (CNS) disorders, pulmonary disease, or drugs, | |||
postoperative nausea, pain,stress,Neoplasia (common),trauma,pregnancy | |||
* '''High fluid intake:''' Physical activity, surgery, primary polydipsia, potomania | |||
(caused by a low intake of solutes with relatively high fluid intake) | |||
* '''Medical testing''' (excess fluid intake) ''':'''Colonoscopy or cardiac catheterization | |||
* '''Hypothyroidism''' | |||
* '''Glucocorticoid deficiency''' | |||
* '''Reset osmostat †''' | |||
* '''Iatrogenic''' | |||
|} | |||
===Causes by Organ System=== | ===Causes by Organ System=== | ||
{| style="width:80%; height:100px" border="1" | {| style="width:80%; height:100px" border="1" | ||
| style="width:25%" bgcolor=" | | style="width:25%" bgcolor="lightsteelblue" ; border="1" | '''Cardiovascular''' | ||
| style="width:75%" bgcolor=" | | style="width:75%" bgcolor="beige" ; border="1" | [[Congestive heart failure ]] | ||
|- | |- | ||
|- bgcolor=" | |- bgcolor="lightsteelblue" | ||
| '''Chemical / poisoning''' | | '''Chemical / poisoning''' | ||
| bgcolor=" | | bgcolor="beige" | No underlying causes | ||
|- | |- | ||
|- bgcolor=" | |- bgcolor="lightsteelblue" | ||
| '''Dermatologic''' | | '''Dermatologic''' | ||
| bgcolor=" | | bgcolor="beige" | [[Burns]] | ||
|- | |- | ||
|- bgcolor=" | |- bgcolor="lightsteelblue" | ||
| '''Drug Side Effect''' | | '''Drug Side Effect''' | ||
| bgcolor=" | | bgcolor="beige" | [[ACE inhibitors]], [[Ajuga nipponensis makino ]] , [[Asenapine maleate]], [[Cefpodoxime]], [[Chlorpropamide]], [[Cyclophosphamide]], [[Desmopressin]], [[Diuretics]], [[Duloxetine]], [[Eslicarbazepine acetate]], [[Ethacrynic Acid]], [[Felbamate]], [[Fluvoxamine]], [[Interferon gamma]], [[Ixabepilone]], [[Losartan and Hydrochlorothiazide]], [[Nilotinib]], [[Nivolumab]], [[Nonsteriodal anti-inflammatory drugs ]] , [[Oxcarbazepine]], [[Pramipexole]], [[Rifaximin]], [[Tiagabine]], [[Tolazamide]], [[Zonisamide]], [[Tolbutamide]], [[Vortioxetine]] | ||
|- | |- | ||
|- bgcolor=" | |- bgcolor="lightsteelblue" | ||
| '''Ear Nose Throat''' | | '''Ear Nose Throat''' | ||
| bgcolor=" | | bgcolor="beige" | No underlying causes | ||
|- | |- | ||
|- bgcolor=" | |- bgcolor="lightsteelblue" | ||
| '''Endocrine''' | | '''Endocrine''' | ||
| bgcolor=" | | bgcolor="beige" | [[Addison's disease]], [[Corticosterone methyloxidase type I deficiency ]] , [[Diabetes mellitus]], [[Diabetic coma]], [[Glucocorticoid deficiency]], [[Familial hyperreninemic hypoaldosteronism type 2]], [[Hypothyroidism]], [[Mineralocorticoid deficiency]], [[Myxedema coma ]] , [[Syndrome of inappropriate antidiuretic hormone ]] , [[Thyrotropin deficiency]], [[18-Hydroxylase deficiency ]] , [[Familial hypoaldosteronism ]] | ||
|- | |- | ||
|- bgcolor=" | |- bgcolor="lightsteelblue" | ||
| '''Environmental''' | | '''Environmental''' | ||
| bgcolor=" | | bgcolor="beige" | No underlying causes | ||
|- | |- | ||
|- bgcolor=" | |- bgcolor="lightsteelblue" | ||
| '''Gastroenterologic''' | | '''Gastroenterologic''' | ||
| bgcolor=" | | bgcolor="beige" | [[Acute liver failure ]] , [[Cirrhosis]], [[Congenital chloride diarrhea ]] , [[Diarrhea]], [[Gastrointestinal fistula]], [[Ileus]], [[Necrotizing enterocolitis ]] , [[Pancreatitis]], [[Peritonitis]], [[Vomiting]], [[Cystic fibrosis]] | ||
|- | |- | ||
|- bgcolor=" | |- bgcolor="lightsteelblue" | ||
| '''Genetic''' | | '''Genetic''' | ||
| bgcolor=" | | bgcolor="beige" | [[18-Hydroxylase deficiency ]] , [[Bartter Syndrome type 4 ]] , [[Cystic fibrosis]], [[Familial hypoaldosteronism ]] , [[Corticosterone methyloxidase type I deficiency ]] , [[Familial hyperreninemic hypoaldosteronism type 2]], [[Congenital chloride diarrhea ]] | ||
|- | |- | ||
|- bgcolor=" | |- bgcolor="lightsteelblue" | ||
| '''Hematologic''' | | '''Hematologic''' | ||
| bgcolor=" | | bgcolor="beige" | No underlying causes | ||
|- | |- | ||
|- bgcolor=" | |- bgcolor="lightsteelblue" | ||
| '''Iatrogenic''' | | '''Iatrogenic''' | ||
| bgcolor=" | | bgcolor="beige" | [[After pituitary surgery]], [[After surgery]], [[Ascitic tap]], [[Gastric drainage]], [[Hypotonic infusions]], [[Pleuracentesis]] | ||
|- | |- | ||
|- bgcolor=" | |- bgcolor="lightsteelblue" | ||
| '''Infectious Disease''' | | '''Infectious Disease''' | ||
| bgcolor=" | | bgcolor="beige" | [[Malignant boutonneuse fever ]] , [[Neonatal bacterial meningitis ]] , [[Peritonitis]] | ||
|- | |- | ||
|- bgcolor=" | |- bgcolor="lightsteelblue" | ||
| '''Musculoskeletal / Ortho''' | | '''Musculoskeletal / Ortho''' | ||
| bgcolor=" | | bgcolor="beige" | No underlying causes | ||
|- | |- | ||
|- bgcolor=" | |- bgcolor="lightsteelblue" | ||
| '''Neurologic''' | | '''Neurologic''' | ||
| bgcolor=" | | bgcolor="beige" | [[Intracranial hemorrhage]], [[Subarachnoid hemorrhage]], [[Pituitary cancer]] | ||
|- | |- | ||
|- bgcolor=" | |- bgcolor="lightsteelblue" | ||
| '''Nutritional / Metabolic''' | | '''Nutritional / Metabolic''' | ||
| bgcolor=" | | bgcolor="beige" | [[Hyperlipidemia]], [[Hyperproteinemia]], [[Hypoalbuminemia]], [[Low sodium diet]], [[Metabolic acidosis]], [[Diabetic coma]] | ||
|- | |- | ||
|- bgcolor=" | |- bgcolor="lightsteelblue" | ||
| '''Obstetric/Gynecologic''' | | '''Obstetric/Gynecologic''' | ||
| bgcolor=" | | bgcolor="beige" | [[Pregnancy]] | ||
|- | |- | ||
|- bgcolor=" | |- bgcolor="lightsteelblue" | ||
| '''Oncologic''' | | '''Oncologic''' | ||
| bgcolor=" | | bgcolor="beige" | [[Pituitary cancer]] | ||
|- | |- | ||
|- bgcolor=" | |- bgcolor="lightsteelblue" | ||
| '''Opthalmologic''' | | '''Opthalmologic''' | ||
| bgcolor=" | | bgcolor="beige" | No underlying causes | ||
|- | |- | ||
|- bgcolor=" | |- bgcolor="lightsteelblue" | ||
| '''Overdose / Toxicity''' | | '''Overdose / Toxicity''' | ||
| bgcolor=" | | bgcolor="beige" | [[Water intoxication]] | ||
|- | |- | ||
|- bgcolor=" | |- bgcolor="lightsteelblue" | ||
| '''Psychiatric''' | | '''Psychiatric''' | ||
| bgcolor=" | | bgcolor="beige" | [[Psychogenic polydipsia]], [[Psychosis]], [[Self-induced water intoxication and schizophrenic disorders syndrome ]] | ||
|- | |- | ||
|- bgcolor=" | |- bgcolor="lightsteelblue" | ||
| '''Pulmonary''' | | '''Pulmonary''' | ||
| bgcolor=" | | bgcolor="beige" | [[Cystic fibrosis]] | ||
|- | |- | ||
|- bgcolor=" | |- bgcolor="lightsteelblue" | ||
| '''Renal / Electrolyte''' | | '''Renal / Electrolyte''' | ||
| bgcolor=" | | bgcolor="beige" | [[Acute kidney disease]], [[Chronic kidney disease]], [[Diuresis]], [[Glucosuria]], [[Ketonuria]], [[Nephrotic syndrome]], [[Renal Tubular Acidosis]], [[Tubulointerstitial kidney disease]], [[Bartter Syndrome type 4 ]] , [[Corticosterone methyloxidase type I deficiency ]] , [[Renal failure]] | ||
|- | |- | ||
|- bgcolor=" | |- bgcolor="lightsteelblue" | ||
| '''Rheum / Immune / Allergy''' | | '''Rheum / Immune / Allergy''' | ||
| bgcolor=" | | bgcolor="beige" | [[Addison's disease]], [[Nephrotic syndrome]] | ||
|- | |- | ||
|- bgcolor=" | |- bgcolor="lightsteelblue" | ||
| '''Sexual''' | | '''Sexual''' | ||
| bgcolor=" | | bgcolor="beige" | [[Cystic fibrosis]] | ||
|- | |- | ||
|- bgcolor=" | |- bgcolor="lightsteelblue" | ||
| '''Trauma''' | | '''Trauma''' | ||
| bgcolor=" | | bgcolor="beige" | [[Burns]] | ||
|- | |- | ||
|- bgcolor=" | |- bgcolor="lightsteelblue" | ||
| '''Urologic''' | | '''Urologic''' | ||
| bgcolor=" | | bgcolor="beige" | No underlying causes | ||
|- | |- | ||
|- bgcolor=" | |- bgcolor="lightsteelblue" | ||
| '''Dental''' | | '''Dental''' | ||
| bgcolor=" | | bgcolor="beige" | No underlying causes | ||
|- | |- | ||
|- bgcolor=" | |- bgcolor="lightsteelblue" | ||
| '''Miscellaneous''' | | '''Miscellaneous''' | ||
| bgcolor=" | | bgcolor="beige" | [[Beer potomania]], [[Ecstasy abuse ]] , [[Factitious hyponatremia]], [[Hydration]], [[Massive edema]], [[Pseudohyponatremia]], [[Water Intoxication ]] , [[Hyperlipidemia]], [[Hyperproteinemia]], [[Hypoalbuminemia]], [[Exercise associated hyponatremia]] | ||
|- | |- | ||
|} | |} |
Revision as of 00:06, 26 April 2018
Hyponatremia Microchapters |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
Disease name] may be caused by [cause1], [cause2], or [cause3].
OR
Common causes of [disease] include [cause1], [cause2], and [cause3].
OR
The most common cause of [disease name] is [cause 1]. Less common causes of [disease name] include [cause 2], [cause 3], and [cause 4].
OR
The cause of [disease name] has not been identified. To review risk factors for the development of [disease name], click here.
Causes
Common Causes
Volume status | Sodium status | Causes |
---|---|---|
Hypovolemic
Hyponatremia |
|
Bicarbonaturia ( Renal tubular acidosis, Metabolic alkalosis), Osmotic diuresis
|
Hypervolemic
Hyponatremia |
|
(due to relatively higher water versus salt intake and poor excretion),Nephrotic syndrome
|
Euvolemic
Hyponatremia |
|
postoperative nausea, pain,stress,Neoplasia (common),trauma,pregnancy
(caused by a low intake of solutes with relatively high fluid intake)
|
Causes by Organ System
Causes in Alphabetical Order