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Hypoosmolar hyponatremia is a condition where hyponatremia is associated with a low plasma osmolality. [1] The term "hypotonic hyponatremia" is also sometimes used.[2]When the plasma osmolarity is low, the extracellular fluid volume status may be in one of three states: low volume, normal volume, or high volume.
It is often simply referred to as "hyponatremia." Hypotonic hyponatremia is categorized in 3 ways based on the person's blood volume status. Each category represents a different underlying reason for the increase in ADH that led to the water retention and thence hyponatremia:
In 1953, Leaf et al, demonstrated that exogenous administration of the antidiuretic hormone vasopressin resulted in hyponatremia and a natriuresis dependent on water retention and weight gain. This was not "salt wasting"; it was a physiologic response to an expanded intravascular volume.
Sodium is also key to maintaining the volume of water in the blood stream; of the water not in the cells about two-thirds is interstitial — between the cells. The normal blood sodium ...
However, if portion sizes are inadequate, a person may not be consuming enough protein and salt. When combined with excessive water intake, this results in insufficient solute concentration. Patients with poor kidney function, or low glomerular filtration rate, are at even higher risk of hyponatremia due to increased water retention. [2]
[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. [14] [3] Diagnosis of the cause of hyponatremia relies on three factors: volume status, plasma osmolality, urine sodium levels and urine osmolality. [14] [3]
Fluid retention can be a symptom of underlying conditions such as kidney disease, heart failure and liver disease, says Badgett. Certain cancers and cancer treatments can cause edema. “Sometimes ...
Improper administration of intravenous fluids, isotonic or hypotonic. [21] Excessive water intake, syndrome of inappropriate antidiuretic hormone (SIADH). [21] Rapid reduction of blood glucose in diabetic ketoacidosis or hyperosmolar hyperglycemic state. [18] [21] Hemodialysis has been associated with ionic edema and cellular swelling. [18]