Hyponatremia risk factors
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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, the most common electrolyte abnormality, is more common in patients with chronic underlying diseases. Certain drugs, low body weight and previous history of hyponatremia are the most prominent risk factors for developing hyponatremia.
Risk Factors
- Strenuous exercises like the marathon and triathlon runner [1]
- Institutionalize schizophrenic patients
- Excess intake of water with no protein intake (↓ urea excretion causes ↓water excretion) like potomania, tea and toast diet
- Diuretics especially thiazides ( older age, female gender, low body weight, the tendency to increased water intake, decreased diluting ability of kidney, and hypokalemia increase the risk for thiazide associated hyponatremia) [2]
- Severe hyponatremia with using benzodiazepine and diuretics simultaneously
- Drugs with different mechanisms
- Chronic diseases like cirrhosis, congestive heart failure, hypertension, diabetes and severe kidney disease [3]
- Low body weight
- Hospitalized patients those with pneumonia, persons admitted to Intensive care unit, post surgery, patients with central nervous system disorder and patients receiving hypotonic fluid [4]
- Elderly patients, those who had previous episodes of hyponatremia [5]
- Trans sphenoidal surgery (TSS) for pituitary adenomas may stretch the pituitary stalk and impair neurohypophyseal function (the risk of hyponatremia increased with increased DS (Diaphragma sellae) sinking depth, a larger pituitary stalk deviation angle difference, and a longer postoperative “measurable pituitary stalk” by MRI. [6]
- Cases of acute hyponatremia following religious fast have been recorded. Reproductive-age women are uniquely susceptible to hyponatremia and dangerous sequelae therein. Fasting individuals, particularly lactating women, due to reduced milk supply after fasting may consume water alone, which can lead to dangerous hyponatremia. [7]
- More recently, COVID 19 patients have been found to have an increased risk of developing hyponatremia. Nearly one- third of coronavirus disease patients were found to develop hyponatremia.[8]
References
- ↑ Christopher S. D. Almond, Andrew Y. Shin, Elizabeth B. Fortescue, Rebekah C. Mannix, David Wypij, Bryce A. Binstadt, Christine N. Duncan, David P. Olson, Ann E. Salerno, Jane W. Newburger & David S. Greenes (2005). "Hyponatremia among runners in the Boston Marathon". The New England journal of medicine. 352 (15): 1550–1556. doi:10.1056/NEJMoa043901. PMID 15829535. Unknown parameter
|month=ignored (help) - ↑ Alexander A. Leung, Adam Wright, Valeria Pazo, Andrew Karson & David W. Bates (2011). "Risk of thiazide-induced hyponatremia in patients with hypertension". The American journal of medicine. 124 (11): 1064–1072. doi:10.1016/j.amjmed.2011.06.031. PMID 22017784. Unknown parameter
|month=ignored (help) - ↑ Liamis, George; Rodenburg, Eline M.; Hofman, Albert; Zietse, Robert; Stricker, Bruno H.; Hoorn, Ewout J. (2013). "Electrolyte Disorders in Community Subjects: Prevalence and Risk Factors". The American Journal of Medicine. 126 (3): 256–263. doi:10.1016/j.amjmed.2012.06.037. ISSN 0002-9343.
- ↑ K. A. Neville, C. F. Verge, A. R. Rosenberg, M. W. O'Meara & J. L. Walker (2006). "Isotonic is better than hypotonic saline for intravenous rehydration of children with gastroenteritis: a prospective randomised study". Archives of disease in childhood. 91 (3): 226–232. doi:10.1136/adc.2005.084103. PMID 16352625. Unknown parameter
|month=ignored (help) - ↑ T. J. Wilkinson, E. J. Begg, A. C. Winter & R. Sainsbury (1999). "Incidence and risk factors for hyponatraemia following treatment with fluoxetine or paroxetine in elderly people". British journal of clinical pharmacology. 47 (2): 211–217. PMID 10190657. Unknown parameter
|month=ignored (help) - ↑ Lin, Kunzhe; Li, Jun; Lu, Lingling; Zhang, Shangming; Mu, Shuwen; Pei, Zhijie; Wang, Cheng; Lin, Jingying; Xue, Liang; Wei, Liangfeng; Zhao, Lin; Wang, Shousen (2021). "Diaphragma sellae sinking can predict the onset of hyponatremia after transsphenoidal surgery for pituitary adenomas". Journal of Endocrinological Investigation. doi:10.1007/s40618-021-01611-7. ISSN 1720-8386.
- ↑ Rosen, Raphael J.; Bomback, Andrew S. (2021). "Acute Hyponatremia After a Religious Fast". AACE Clinical Case Reports. 7 (4): 236–238. doi:10.1016/j.aace.2021.02.005. ISSN 2376-0605.
- ↑ Frontera, Jennifer A.; Valdes, Eduard; Huang, Joshua; Lewis, Ariane; Lord, Aaron S.; Zhou, Ting; Kahn, D. Ethan; Melmed, Kara; Czeisler, Barry M.; Yaghi, Shadi; Scher, Erica; Wisniewski, Thomas; Balcer, Laura; Hammer, Elizabeth (2020). "Prevalence and Impact of Hyponatremia in Patients With Coronavirus Disease 2019 in New York City". Critical Care Medicine. 48 (12): e1211–e1217. doi:10.1097/CCM.0000000000004605. ISSN 0090-3493.