Hyponatremia

DEFINITIONS

Hyponatremia (blood sodium levels are low) is the sodium concentration of less than 136 mEq / L blood.

CAUSE

Blood sodium concentration decreased when sodium was dissolved by too much water in the body.
Dilution of sodium can occur in people who drink water in very many (as sometimes happens to certain psychological disorders) and in patients treated in hospitals, which receive large amounts of intravenous fluids.
The amount of fluid in the kidneys exceeds the ability to remove the excess.

Fluid intake in a smaller amount (sometimes as many as 1L/hari), can lead to hyponatremia in those kidneys are not functioning properly, for example in kidney failure.

Hyponatraemia is common in people with heart failure and cirrhosis of the liver, which increases blood volume.
In these circumstances, an increase in blood volume causes dilution of sodium, although the total amount of sodium in the body usually increase as well.

Hyponatraemia occurs in people who are not functioning adrenal glands (Addison's disease), which was issued in the amount of sodium very much.
Disposal of sodium into the urine caused by lack of hormone aldosterone.

Patients with Syndrome of Inappropriate Secretion of antidiuretic hormone (SIADH) has low concentrations of sodium since the pituitary gland at the base of the brain out too much of antidiuretic hormone.

Antidiuretic hormone causes the body to retain water and dissolve some sodium in the blood.
Causes of SIADH:

1. Meningitis and encephalitis
2. Brain tumor
3. Psychosis
4. Lung disease (including pneumonia and acute respiratory failure)
5. Cancer (especially lung and pancreatic cancer)
6. Drugs:
- Chlorpropamide (drug that lowers blood sugar levels)
- Carbamazepine (anti-seizure medication)
- Vincristine (anti-cancer drugs)
- Clofibrate (drugs that lower cholesterol)
- Anti-drugs psychosis
- Aspirin, ibuprofen and other analgesic sold freely
- Vasopressin and oxytocin (artificial antidiuretic hormone).

SYMPTOMS

Weighing symptoms is partly determined by the speed of blood sodium levels decrease.
If sodium levels decreased gradually, the symptoms tend to be not serious and did not appear until the sodium level was low.
When sodium levels decline rapidly, resulting symptoms more severe and even decline slightly, but the symptoms tend to arise.

The brain is very sensitive to changes in blood sodium concentration. Therefore, the early symptoms of hyponatremia are lethargy (decreased state of consciousness as deep sleep, can be aroused briefly, but soon fell asleep again).

In line with worsening hyponatremia, the muscles become stiff and seizures can occur.
In very severe cases, will be followed by stupor (decreased consciousness in part) and coma.

Diagnosis

Diagnosis based on results of blood tests and symptoms.

TREATMENT

Severe hyponatremia is an emergency that requires immediate treatment.

Given intravenous fluids to increase blood sodium concentrations slowly.
The increase in concentration that is too fast can cause permanent brain damage.

Controlled fluid intake is restricted and causes of hyponatremia resolved.
If he deteriorates or does not show improvement after such restrictions on fluid intake, it is given demeclocycline in SIADH or thiazide diuretics to reduce the effects of antidiuretic hormone on kidney.