Hyponatremia natural history, complications and prognosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Natural History, Complications and Prognosis
The outcome depends on the condition that is causing the problem. In general, acute hyponatremia, which occurs in less than 48 hours, is more dangerous than hyponatremia that develops slowly over time. When sodium levels fall slowly over a period of days or weeks (chronic hyponatremia), the brain cells have time to adjust and swelling is minimal.
Chronic hyponatremia can lead to such complications as neurological impairments. These neurological impairments most often affect gait and attention and can lead to falls, osteoporosis, and slowed reaction time.
Complications for chronic hyponatremia are most dangerous for geriatric patients. Falls are the leading cause of deaths related to injury among people 65 years or older. In a recent study[1] the incidence of hyponatremia in elderly patients with large-bone fractures was more than double that of non-fracture patients. Recent work by Verbalis et al.[2] suggests that hyponatremia induces osteoporosis and found the adjusted odds ratio for developing osteoporosis to be 2.87 times higher among adults with mild hyponatremia compared to those without.
Acute hyponatremia can lead to much more serious complications including brain disease, brain herniation, cardiopulmonary arrest, cerebral edema, seizures, coma, and death.
References
- ↑ Harminder, S. Sandhu et al. "Hyponatremia associated with large-bone fracture in elderly patients." Int Urol Nephrol (2009) 41:733-737.
- ↑ Ayus, Juan Carlos and Michael L. Moritz. "Bone Disease as a New Complication of Hyponatremia: Moving Beyond Brain Injury". CJASN ePress. Jan 14, 2010. 10.2215/CJN.09281209.