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Normally, when mild hyponatremia begins to occur, that is, the serum sodium begins to fall below 135 mEq/L, there is no secretion of ADH, and the kidney stops returning water to the body from the kidney tubule. Also, no thirst is experienced. These two act in concert to raise the serum sodium to the normal range. [30] [31] [32]
Hypernatremia is generally defined as a serum sodium level of more than 145 mmol/L. [3] Severe symptoms typically only occur when levels are above 160 mmol/L. [1] Hypernatremia is typically classified by a person's fluid status into low volume , normal volume, and high volume . [ 1 ]
Normal serum sodium levels are between approximately 135 and 145 mEq/L (135 to 145 mmol/L). A serum sodium level of less than 135 mEq/L qualifies as hyponatremia, which is considered severe when the serum sodium level is below 125 mEq/L. [14] [15]
A reference range is usually defined as the set of values 95 percent of the normal population falls ... Sodium (Na) 135, [14] 137 [5 ... Serum levels: 70–79 years, ...
This keeps serum sodium concentration – a proxy for solute concentration – at normal levels, prevents hypernatremia and turns off the osmoreceptors. [7] Specifically, when the serum sodium rises above 142 mEq/L, ADH secretion is maximal (and thirst is stimulated as well); when it is below 135 mEq/L, there is no secretion. [8]
EAH is categorized by having a blood serum or plasma sodium level below normal, which is less than 135 mmol/L. [1] Asymptomatic EAH is not normally detected unless the athlete has had a sodium blood serum or plasma test. [1] Hyponatremic encephalopathy may be detected using brain imaging studies and pulmonary edema may be confirmed by x-ray.
The kidneys can also generate dilute urine to balance sodium levels. [8] These electrolytes must be replaced to keep the electrolyte concentrations of the body fluids constant. Hyponatremia, or low sodium, is the most commonly seen type of electrolyte imbalance. [12] [13]
It is important to note that sudden restoration of blood volume to normal will turn off the stimulus for continued ADH secretion. Hence, a prompt water diuresis will occur. This can cause a sudden and dramatic increase in the serum sodium concentration and place the patient at risk for so-called "central pontine myelinolysis" (CPM). CPM is a ...