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A blood test demonstrating a serum sodium less than 135 mmol/L is diagnostic for hyponatremia. [34] The history and physical exam are necessary to help determine if the person is hypovolemic, euvolemic, or hypervolemic, which has important implications in determining the underlying cause.
High volume hypernatremia can be due to hyperaldosteronism, excessive administration of intravenous normal saline or sodium bicarbonate, or rarely from eating too much salt. [1] [2] Low blood protein levels can result in a falsely high sodium measurement. [4] The cause can usually be determined by the history of events. [1]
Acid–base and blood gases are among the few blood constituents that exhibit substantial difference between arterial and venous values. [6] Still, pH, bicarbonate and base excess show a high level of inter-method reliability between arterial and venous tests, so arterial and venous values are roughly equivalent for these. [44]
The version with seven tests is often referred to by medical professionals in the United States as the "CHEM-7", or "SMA-7" (Sequential Multiple Analysis-7). [1] The seven parts of a CHEM-7 are tests for: Four electrolytes: sodium (Na +) [2] potassium (K +) [3] chloride (Cl −) [4] bicarbonate (HCO 3 −) or CO 2 [5] blood urea (BU), blood ...
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.
Pseudohyponatremia is a false low sodium reading that can be caused by high levels of fats or proteins in the blood. [14] [3] Dilutional hyponatremia can happen in diabetics as high glucose levels pull water into the blood stream causing the sodium concentration to be lower.
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Doing so lessens the chance of increaseing the serum sodium level too rapidly as blood volume rises and ADH levels fall. [citation needed] In people who are volume depleted (e.g., their blood volume is too low), ADH secretion is increased since volume depletion is a potent stimulus for ADH secretion.
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