General Practice 2022

Hyponatremia: what é, symptoms, causes and treatment

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Hyponatremia: what é, symptoms, causes and treatment
Hyponatremia: what é, symptoms, causes and treatment

Hyponatremia is a decrease in the amount of sodium in the body, which is identified in the blood test when potassium values ​​are below 135 mEq/L. This condition is more common in hospitalized patients.

Hyponatremia is a potentially dangerous situation, because the lower the level of sodium in the blood, the greater the severity of the symptoms, which can lead to swelling of the brain, seizures and, in some cases, coma.

The treatment of hyponatremia is done by replacing the amount of sodium in the blood through the administration of serum, which must be prescribed by the doctor in the necessary amount according to each case.

Main symptoms

The most common symptoms of hyponatremia are:

  • Headache;
  • Confusion;
  • Sickness;
  • Vomiting;
  • Muscle weakness;
  • Drowsiness.

The signs and symptoms of hyponatremia are more severe as the amount of sodium in the blood decreases. In the most severe cases, there may be seizures, muscle spasms and coma.

Hyponatremia that causes symptoms is considered a medical emergency and should be detected and treated as soon as possible.

Possible causes of hyponatremia

Decreased concentration of sodium in the blood results from any disease that causes a decrease in the amount of water eliminated by the body, or when water accumulates in greater quantity in the blood, so that the sodium is diluted.

Vopressin is the hormone responsible for regulating the amount of water in the body, being released by the pituitary gland when there is low blood volume, low blood pressure or when there is a large amount of circulating sodium. However, in some situations there may be dysregulation of the amount of vasopressin produced, resulting in hyponatremia. Thus, some of the main causes of hyponatremia are:

  • Excessive blood sugar, which happens in diabetes;
  • Vomiting or diarrhea, which causes both hyponatremia and hypernatremia;
  • Diseases that accumulate fluid in the body, such as heart failure, cirrhosis of the liver, severe hypothyroidism, and chronic kidney failure;
  • Diseases and conditions that produce excess vasopressin;
  • Use of medications that can retain water, such as some anti-inflammatories;
  • Excessive physical exercise, such as in marathons, which stimulates the body to produce antidiuretic hormone, in addition to consuming more water;
  • Using drugs such as Ecstasy;
  • Excessive consumption of liquids, such as beer, teas, and even water.

Drinking too much fluid to the point of causing hyponatremia can happen in psychiatric situations, such as potomania, in which beer is drunk excessively, or psychogenic polydipsia, in which the person drinks more water than necessary.

For athletes, the ideal is not to exaggerate the amount drunk during exercise, because about 150 ml of water for every 1 hour of exercise is enough. If you feel thirstier than that, you should drink another isotonic drink, such as Gatorade, which contains important minerals, maintaining blood control.

How to confirm the diagnosis

The diagnosis of hyponatremia is made through the measurement of sodium in the blood, in which a concentration lower than 135 mEq/L is verified. Ideally, sodium values ​​should be between 135 and 145 mEq/L.

The diagnosis of the cause is made by the doctor, who investigates changes based on the clinical history and other blood tests, such as the evaluation of kidney and liver function, blood glucose levels, and blood concentration and of urine, which help determine the origin of the change.

How the treatment is done

To treat hyponatremia, the doctor must identify the intensity of the symptoms, and whether it is an acute or chronic change. In severe acute hyponatremia, or when it causes symptoms, serum replacement is performed with a greater amount of sodium, which is hypertonic saline solution.

This replacement must be carefully calculated, according to each person's sodium need and done slowly, as the sudden change in sodium levels or excess sodium, which is hypernatremia, can also be harmful to brain cells. Learn more about what causes and how to treat hypernatremia.

Chronic hyponatremia can also be treated with hypertonic saline or saline solution, and a quick correction is not necessary, as the body is already adapting to that condition. In mild situations, another option is to restrict the amount of water you drink in the day, which can make the blood have a better balance of water and s alt.

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