{"id":1272,"date":"2017-06-15T07:06:06","date_gmt":"2017-06-15T07:06:06","guid":{"rendered":"http:\/\/papergp.com\/index.php\/data-interpretation\/hyponatraemia\/"},"modified":"2023-01-24T11:25:25","modified_gmt":"2023-01-24T11:25:25","slug":"hyponatraemia","status":"publish","type":"page","link":"https:\/\/papergp.com\/index.php\/data-interpretation\/ues\/hyponatraemia\/","title":{"rendered":"Hyponatraemia"},"content":{"rendered":"<div class=\"content-box-blue\">\n<h4>Data gathering<\/h4>\n<ul>\n<li>Severity\n<ul>\n<li>Mild 125-133<\/li>\n<li>Moderate 115-125<\/li>\n<li>Severe Na &lt;115 or symptomatic<\/li>\n<\/ul>\n<\/li>\n<li>Acute vs chronic\n<ul>\n<li>acute &#8211; rare, most often due to marked water intake &#8211; high morbidity<\/li>\n<li>chronic &#8211; common, avoid rapid correction (to avoid osomotic demyelination syndrome)<\/li>\n<\/ul>\n<\/li>\n<li>Pseudohyponatraemia &#8211; high glucose, high triglycerides, high paraproteinaemia<\/li>\n<li>Presentation\n<ul>\n<li>cognitive decline, lethargy, nausea, anorexia, seizures, coma<\/li>\n<\/ul>\n<\/li>\n<li>Causes\n<ul>\n<li>Hypovolaemia\n<ul>\n<li>Diuretics, D&amp;V, AKI, Renal disease, Addison&#8217;s disease<\/li>\n<\/ul>\n<\/li>\n<li>Euvolaemia\n<ul>\n<li>Medications &#8211; thiazides, ACE-I, antidepressants, antiepileptics, PPIs<\/li>\n<li>SIADH, Hypothyroidism, Hypopituitarism, Low salt intake, Chronic alcoholism, Polydipsia<\/li>\n<\/ul>\n<\/li>\n<li>Hypervolaemia\n<ul>\n<li>CCF, chronic liver disease, nephrotic syndrome, protein losing enteropathy<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/div>\n<p>&nbsp;<\/p>\n<div class=\"content-box-blue\">\n<h4>Clinical management<\/h4>\n<ul>\n<li>Investigations &#8211; urine dip (renal disease\/UTI), TFTs, 9am cortisol, paired urinary\/serum sodium (same day)<\/li>\n<li>Treatment\n<ul>\n<li>Fluid overload &#8211; treat underlying condition e.g. fluid restrict\/diuresis<\/li>\n<li>Dehydration &#8211; treat underlying condition and rehydrate<\/li>\n<li>Medications &#8211; stop causative medications and repeat Na in 1 week<\/li>\n<\/ul>\n<\/li>\n<li>Consider other conditions &#8211; chest infections, GI disease, CCF, liver disease, myeloma, malignancy<\/li>\n<li>Followup \/ Who to admit\n<ul>\n<li>Symptomatic<\/li>\n<li>Na &lt; 115<\/li>\n<li>Hypovolaemic<\/li>\n<li>Rapid progression<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/div>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Data gathering Severity Mild 125-133 Moderate 115-125 Severe Na &lt;115 or symptomatic Acute vs chronic acute &#8211; rare, most often due to marked water intake &#8211; high morbidity chronic &#8211; common, avoid rapid correction (to avoid osomotic demyelination syndrome) Pseudohyponatraemia &#8211; high glucose, high triglycerides, high paraproteinaemia Presentation cognitive decline, lethargy, nausea, anorexia, seizures, coma &hellip; <a href=\"https:\/\/papergp.com\/index.php\/data-interpretation\/ues\/hyponatraemia\/\" class=\"more-link\">Continue reading <span class=\"screen-reader-text\">Hyponatraemia<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"parent":1269,"menu_order":15,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-1272","page","type-page","status-publish","hentry"],"jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/1272","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/comments?post=1272"}],"version-history":[{"count":5,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/1272\/revisions"}],"predecessor-version":[{"id":1879,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/1272\/revisions\/1879"}],"up":[{"embeddable":true,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/1269"}],"wp:attachment":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/media?parent=1272"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}