Hyponatremia causes: Difference between revisions
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|'''<big>Hypertonic Hyponatremia</big>''' | |'''<big>Hypertonic Hyponatremia</big>''' | ||
|> 295 mOsm/kg | |> 295 mOsm/kg | ||
| | |Hyperglycemia<sup>‡</sup>, Mannitol, Glycerol, Sorbitol | ||
|- | |- | ||
|'''<big>Isotonic Hyponatremia</big>''' | |'''<big>Isotonic Hyponatremia</big>''' | ||
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|Etiology depends upon volume status (Hypervolemic/ Euvolemic/ Hypovolemic) | |Etiology depends upon volume status (Hypervolemic/ Euvolemic/ Hypovolemic) | ||
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‡ Hyperglycemia causes osmotic diuresis results in a rise in sodium concentration, on the other hand it leads to increase extracellular shift of water due to osmotic shift, depends on which effect is stronger,there is hyponatremia or hyponatremia( hypertonicity or hypertonicity)<ref>{{Cite journal | |||
| author = [[A. I. Arieff]] & [[H. J. Carroll]] | |||
| title = Nonketotic hyperosmolar coma with hyperglycemia: clinical features, pathophysiology, renal function, acid-base balance, plasma-cerebrospinal fluid equilibria and the effects of therapy in 37 cases | |||
| journal = [[Medicine]] | |||
| volume = 51 | |||
| issue = 2 | |||
| pages = 73–94 | |||
| year = 1972 | |||
| month = March | |||
| pmid = 5013637 | |||
}}</ref> | |||
* Causes of '''<big>Hyponatremia</big>''' based on '''volume status''' '''<ref name="GuillauminDiBartola2017">{{cite journal|last1=Guillaumin|first1=Julien|last2=DiBartola|first2=Stephen P.|title=A Quick Reference on Hyponatremia|journal=Veterinary Clinics of North America: Small Animal Practice|volume=47|issue=2|year=2017|pages=213–217|issn=01955616|doi=10.1016/j.cvsm.2016.10.003}}</ref> :''' | * Causes of '''<big>Hyponatremia</big>''' based on '''volume status''' '''<ref name="GuillauminDiBartola2017">{{cite journal|last1=Guillaumin|first1=Julien|last2=DiBartola|first2=Stephen P.|title=A Quick Reference on Hyponatremia|journal=Veterinary Clinics of North America: Small Animal Practice|volume=47|issue=2|year=2017|pages=213–217|issn=01955616|doi=10.1016/j.cvsm.2016.10.003}}</ref> :''' | ||
{| class="wikitable" | {| class="wikitable" |
Revision as of 05:15, 29 April 2018
Hyponatremia Microchapters |
Diagnosis |
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Treatment |
Case Studies |
Hyponatremia causes On the Web |
American Roentgen Ray Society Images of Hyponatremia causes |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Saeedeh Kowsarnia M.D.[2]
Overview
Disease name] may be caused by [cause1], [cause2], or [cause3].
OR
Common causes of [disease] incl ude [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
Diagnostic criteria of SIADH/SIAD |
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|
† Mmol and Meq are the same for univalent ions like sodium
- Causes of Hyponatremia based upon Serum Osmolality:
Classification | Serum Osmolality | Etiology |
---|---|---|
Hypertonic Hyponatremia | > 295 mOsm/kg | Hyperglycemia‡, Mannitol, Glycerol, Sorbitol |
Isotonic Hyponatremia | 280 – 295 mOsm/kg | Lab/blood draw error, Hyper paraproteinemia (monoclonal gammopathy of undetermined significance (MGUS),
Multiple Myeloma), Hyperlipidemia, Post TURP (bladder irrigation with osmotic solutions) |
Hypotonic Hyponatremia | < 280 mOsm/kg | Etiology depends upon volume status (Hypervolemic/ Euvolemic/ Hypovolemic) |
‡ Hyperglycemia causes osmotic diuresis results in a rise in sodium concentration, on the other hand it leads to increase extracellular shift of water due to osmotic shift, depends on which effect is stronger,there is hyponatremia or hyponatremia( hypertonicity or hypertonicity)[1]
- Causes of Hyponatremia based on volume status [2] :
Volume status | Sodium status | Causes |
---|---|---|
Hypovolemic
Hyponatremia[3] |
|
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)
|
† Altered sensitivity to serum osmolality by the hypothalamic osmoreceptors
- Drugs [4] :
Drug Mechanisms | Drug Classification |
---|---|
Increase ADH secretion | Antidepressants:Tricyclic antidepressants ( Amitryptiline,
Protriptyline, Desipramine),Selective serotonin reuptake inhibitors, Monoamine oxidase inhibitors Antipsychotic drugs: Phenothiazines (Thioridazine, Trifluoperazine), Butyrophenones (Haloperidol) Antiepileptic drugs: Carbamazepine, Oxcarbazepine, Sodium valproate Anticancer agents: Vinca alkaloids (Vincristine, Vinblastine), Platinum compounds (Cisplatin, Carboplatin) Alkylating agents: Intravenous, Cyclophosphamide, Melphalan, Ifosfamide Miscellaneous: Methotrexate, Interferon, Levamisole, Pentostatin, Monoclonal antibodies, MDMA, Nicotine Opiates |
Increase ADH effect | Antiepileptic drugs: Carbamazepine, Lamotrigine
Antidiabetic drugs: Chlorpropamide, Tolbutamide Anticancer agents: Alkylating agents (Intravenous cyclophosphamide) NSAIDS |
Drugs affecting water and sodium homeostasis | Diuretics:Thiazides, Indapamide, Amiloride, Loop diuretics |
Reset omostat ‡ | Antidepressants: Venlafaxine
Antiepileptic drugs:Carbamazepine |
‡ Altered sensitivity to serum osmolality by the hypothalamic osmoreceptors
Causes by Organ System
Causes in Alphabetical Order
References
- ↑ A. I. Arieff & H. J. Carroll (1972). "Nonketotic hyperosmolar coma with hyperglycemia: clinical features, pathophysiology, renal function, acid-base balance, plasma-cerebrospinal fluid equilibria and the effects of therapy in 37 cases". Medicine. 51 (2): 73–94. PMID 5013637. Unknown parameter
|month=
ignored (help) - ↑ Guillaumin, Julien; DiBartola, Stephen P. (2017). "A Quick Reference on Hyponatremia". Veterinary Clinics of North America: Small Animal Practice. 47 (2): 213–217. doi:10.1016/j.cvsm.2016.10.003. ISSN 0195-5616.
- ↑ Rondon-Berrios, Helbert; Agaba, Emmanuel I.; Tzamaloukas, Antonios H. (2014). "Hyponatremia: pathophysiology, classification, manifestations and management". International Urology and Nephrology. 46 (11): 2153–2165. doi:10.1007/s11255-014-0839-2. ISSN 0301-1623.
- ↑ Liamis, George; Milionis, Haralampos; Elisaf, Moses (2008). "A Review of Drug-Induced Hyponatremia". American Journal of Kidney Diseases. 52 (1): 144–153. doi:10.1053/j.ajkd.2008.03.004. ISSN 0272-6386.