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Hyponatremia or hyponatraemia is a low concentration of sodium in the blood. [4] It is generally defined as a sodium concentration of less than 135 mmol/L (135 mEq/L), with severe hyponatremia being below 120 mEq/L. [3] [8] Symptoms can be absent, mild or severe.
The first is dehydration along with low total body sodium. This is most commonly caused by heatstroke, burns, extreme sweating, vomiting, and diarrhea. [3] The second is low total body water with normal body sodium. This can be caused by diabetes insipidus, renal disease, hypothalamic dysfunction, sickle cell disease, and certain drugs. [3]
Hypovolemia, also known as volume depletion or volume contraction, is a state of abnormally low extracellular fluid in the body. [1] This may be due to either a loss of both salt and water or a decrease in blood volume. [2] [3] Hypovolemia refers to the loss of extracellular fluid and should not be confused with dehydration. [4]
Water follows sodium, Schnoll-Sussman explains, which means the body retains fluid to compensate for excess salt. Malnutrition, high carb diets and deficiencies in potassium or magnesium can also ...
Hence, ADH activity effectively dilutes the blood (decreasing the concentrations of solutes such as sodium), causing hyponatremia; this is compounded by the fact that the body responds to water retention by decreasing aldosterone, thus allowing even more sodium wasting. For this reason, a high urinary sodium excretion will be seen.
The decrease in sodium levels can occur due to a defect in the renal and hormonal systems, an overwhelming increase in water consumption and excessive loss of sodium through sweating. [3] When the sodium levels outside of the cells decrease, water moves into the cells. [7] The cells begin to increase in size.
Low fractional excretion indicates sodium retention by the kidney, suggesting pathophysiology extrinsic to the urinary system such as volume depletion or decrease in effective circulating volume (e.g. low output heart failure). Higher values can suggest sodium wasting due to acute tubular necrosis or other
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