A descriptive study of hyponatremia in a tertiary care hospital of Eastern India (original) (raw)
Related papers
SYMPTOMATIC HYPONATREMIA, ETIOLOGY AND OUTCOME IN A TERTIARY CARE HOSPITAL
ABSTRACT Background: Hyponatremia is one of the common electrolyte abnormalities in hospitalized patients. The spectrum of different etiologies of hyponatremia have both prognostic and therapeutic implications. Aims and Objectives: To evaluate the clinical and etiological profile of hyponatremia, and to study the outcome of hyponatremia. Study Design: A prospective cohort Study. Materials and Methods: A total of 100 consecutive patients clinical history, physical examination, baseline biochemical and metabolic profile followed by serum and urine osmolality and urine sodium was done in all patients. Results: Out of 100 consecutive patients enrolled in this study, thirty-eight were males and sixty-two were females with male to female ratio of 1:1.6, with mean age of 61.2 years. Commonest neurological complaints were confusion (46%), lethargy (20%) and seizures (10%). Diuretic use was the most common cause of hyponatremia 34%, followed by SIADH 29%, gastrointestinal losses 10% and chronic kidney disease in 8% of patients. Chronic liver disease and chronic heart failure contributed 6% each. Other rare causes like hypothyroidism, primary adrenal failure, primary polydipsia and Beer potomania was found in 7% of patients. 46% patients were euvolemic, 37% hypervolemic and 17% hypovolemic. Conclusion: Diuretics are the most common cause of hyponatremia followed by SIADH and gastrointestinal losses. Mortality rate in our study was 12%, with maximum mortality in SIADH group 50%. Key words: Hyponatremia, Euvolemic, Diuretics, SIADH.
Clinical Profile and Outcome of Patients with Hyponatremia at Tertiary Care Teaching Hospital
Journal of Evolution of Medical and Dental Sciences, 2018
BACKGROUND Hyponatremia is defined as a serum sodium concentration less than 135 mmol/L and is the most common electrolyte disorder encountered in clinical practice. MATERIALS AND METHODS This was a retrospective, descriptive and data analysis study conducted over period of 12 month at a tertiary care centre, to study the clinical profile, aetiology, classification and outcome of hyponatremia. A total 115 consecutive cases who had serum sodium levels of <135 mmol/L were enrolled. The mean and standard deviation and percentage for numerical variables were calculated. Chi square test was used to analyse categorical variables. RESULTS Of a total of 115 patients, 73 (63.47%) were male and 42 (36.52%) were females. There was a predominance of Na + levels of 115-134 mmol/L (mild hyponatremia) 59.13% ['p'< 0.001]. The majority of patients (42.61%) had nausea and/or vomiting ('p'<0.001) and confusion, seizures and coma were associated with moderate to profound hyponatremia ('p' <0.01). The SIADH (37.39%) was the commonest pathophysiological process observed in the present study ['p' <0.0001]. Overall mortality was 9.57%. The patients with Sr. Na + <105 mmol/L had (36.84%) significant mortality compared to >105 mmol/L ['p' <0.002196]. The duration of hospital stay was inversely related to Sr. sodium level. CONCLUSION In present cohort of hyponatremia the SIADH was the commonest aetiology. Confusion, seizures and coma were associated with moderate to profound hyponatremia. The duration of hospital stay was inversely related to serum sodium level with overall mortality of 9.57% which was correlated with severity of hyponatremia.
National Journal of Physiology, Pharmacy and Pharmacology, 2017
Background: Hyponatremia, defined as a serum sodium concentration 20 mmol/l, Serum uric acid ≤4 mg/dl, normal renal function (serum creatinine and blood urea) and absence of thyroid or pituitary insufficiency were classified as having Syndrome of inappropriate antidiuresis (SIAD). The sodium estimation was done in the randox automated analyser which measures sodium by ion selective electrode technology. Results: A total of 100 patients with hyponatremia (serum Na+≤130 mEq/L) were included in the study. The mean age of presentation was around 51.5 ± 17.5 years with male to female (M:F) ratio 1.8:1. Severe hyponatremia was detected in 56 patients and the mean sodium level was 118.2 ± 8.1 mEq/L. 43 patients had altered level of consciousness in form of drowsiness, confusion, irrelevant talking or coma, 6 patients had seizure, 38 patients had vomiting, 7 patients had hiccups and 38 hyponatremic patients were asymptomatic. The commonest type of hyponatremia noted in our study was euvolem...
Etiology, Clinical Features and Outcomes of Treatment of Hyponatremia -A Prospective Study
https://www.ijrrjournal.com/IJRR\_Vol.9\_Issue.3\_March2022/IJRR-Abstract051.html, 2022
Hyponatremia is a common problem encountered in patients presenting with nonspecific symptoms. Symptomatology depends more on the rate of development of the electrolyte abnormality than on its severity. Data regarding the incidence of hyponatremia in hospitalized patients in our country is limited. This prospective, descriptive study was conducted at Ramakrishna care hospital Raipur from September 2016-November 2017.100 cases were taken by random sampling method to know the common clinical features etiology and treatment outcome of hospitalized patients and study the morbidity and mortality in such patients. hyponatremia presented with various clinical symptoms out of which nausea was most common followed by vomiting ,altered sensorium and seizure. Physician need to be aware about the common occurrence of hyponatremia and early identification to prevent serious complication like seizures. Over all most common cause of hyponatremia in all 3 group was diuretics and salt restriction (53%). most of hyponatremic patients were hypertensive and number of cases increased from mild to severe hyponatremia secondary to diuretic and salt restriction it was statistically highly significant i.e. 54% (p<0.0001).
Hyponatremia in Hospitalized Patients
Asian journal of multidisciplinary studies, 2018
Objective: Alleviation of cerebral oedema, not to correct sodium. Therefore, provision is only to severely symptomatic patients. Place and Duration of Study: This study was carried out from Jan 2018 to March 2018 at Mayo Hospital, Lahore, Pakistan. Materials and Methods: Out of 3000 patients, 100(3.3%) patients had hyponatremia defined as having level of serum sodium less than 135mmol/L. Among them male patients were 65(65%) and female patients were 35(35%) with average 55 years of age. Results: In 24(22.2%) patients severe hyponatremia (Na+ < 120 mmol/L) was detected. Euvolemic was the largest group of hyponatraemic patients with 42(42%), then hypervolemic patients with 33(33%) and thirdly hypovolemia patients with 25(25%). 4(4%) patients out of 100 patients qualify the criteria for Syndrome of Inappropriate Anti Diuretic Hormone (SIADH). During stay at hospital, 2(2%) out of 100 hyponatraemic patients died. No death was secondary to hyponatremia. No patient was Tolvaptan (a V2R...
Profile of hyponatremia in a tertiary care centre in North India
International Journal of Advances in Medicine, 2016
Hyponatremia defined as serum sodium less than 135 meq/l is the most common electrolyte disorder among hospitalized patients. 1-5 It is associated with mortality and morbidity ranging from 5-50 % depending on severity and acuity of onset. 6 Hyponatremia occurs in a broad spectrum of patients. It affects all age groups and both sexes equally but is most commonly found in elderly persons because of an increase frequency of comorbidities, that can lower serum sodium levels (example cardiac ,hepatic or renal failure). 7-9 Patients in whom the serum sodium concentration is greater than 130 mEq/L are usually asymptomatic, whereas those in whom these values are lower may have symptoms. Symptoms occurring early in hyponatremia are usually anorexia, nausea, vomiting. Some patients may have headache and irritability. As serum sodium levels falls further patients develop neuropsychiatry symptoms. These symptoms range from restlessness, altered consciousness, lethargy, seizures to coma. There ABSTRACT Background: Hyponatremia is the commonest electrolyte imbalance. Hyponatremia is a heterogenous disorder and classified into hypovolemic, euvolemic and hypervolemic types depending on the volume status of the patient. Approach is based on etiology and type of hyponatremia. The aim of the present study was to determine the profile of hyponatremia in adult patients including underlying etiology, type, clinical features and outcome Methods: The study was conducted at BRD medical college Gorakhpur, India between July 2014 to August 2015 after approval by the ethical committee. Consenting patients >18 years of age with hyponatremia (<130meq/l) were included and investigated as per protocol. Based on volume status and urinary sodium patients were classified as euvolemic, hypervolemic and hypovolemic. Results: N = 250, mean age 53.9 years. 56% males, 154(61.6%) patients had euvolemic, 53 (21.2%) hypervolemic and 43(17.2%) hypovolemic hyponatremia. The most common causes for euvolemic, hypervolemic, hypovolemic hyponatremia were CNS infections, CLD and acute gastroenteritis respectively. Neurologic symptoms were more common in severe as compared to mild hyponatremia (69.7% versus 8.1%). Seizures attributable to hyponatremia were seen in 44 patients (17.6%), all with severe hyponatremia. Overall mortality was 14%. Deaths were more frequently seen in patients with severe hyponatremia as compared to patients with mild hyponatremia (25.5% vs. 4.7% P = 0.035). Conclusions: Euvolemic hyponatremia is the most common type seen in hospitalized patients and is associated mainly with intracranial pathologies. Severe hyponatremia is significantly associated with neurological manifestations and higher mortality.
To Assess the Clinical Features of Hyponatremia in Adult Subjects Admitted in SMS Hospital
Saudi Journal of Medicine
Background: Hyponatremia, which is defined as plasma sodium concentration of less than 135meq/L, occurs primarily due to imbalance in water homeostasis, antidiuretic hormone (ADH) regulation and renal handling of filtered sodium. The two most common causes are effective circulating volume depletion causing non-osmotic release of ADH and the syndrome of inappropriate ADH secretion, disorders in which ADH secretion is not suppressed despite decrease in plasma osmolality. Methods: Observational Study conducted at Medicine wards and, Medicine OPD of SMS hospital, Jaipur. Patients were interviewed for demographic data such as age and sex. History of other comorbid conditions along with presenting complaints was noted. Further these patients were subjected to a physical examination for clinical signs. These findings were recorded on a predesigned and pretested proforma. Results: In our study, lethargy(50.4%), headache(42.3%) and anxiety(31.7%) were most common symptoms. Majority of the cases were admitted and treated in the ward i.e. 249(87.7%), while few patients were treated in ICU i.e.35 (12.3%). Conclusion: Based on the findings of this study it may be concluded that, hyponatremia can present with protean clinical manifestations. The presentation can vary from mild symptoms such as vomiting, lethargy, malaise to severe forms such as confusion, seizure and coma.
OBJECTIVE: To determine the frequency, etiology, outcome of hyponatremia at tertiary care hospital PATIENTS AND METHODS: The one year cross sectional survey was conducted from 01 January 2015 to 31 December 2015 at tertiary care hospital Hyderabad. The inclusion criteria of the study were hospitalized patients due to any illness for ≥ 07 days, of ≥12 years of age either gender were be recruited. The serum sodium levels was checked at admission, every day during and then as and when indicated and the serum sodium value <130 mmol/l was labeled as low or hyponatremia while the value <125 mmol /l was labeled as severe hyponatremia. The frequency and percentages (%) was computed while the mean ± SD for also calculated for numerical variables. RESULTS: Total 87 hyponatremic individuals were rationalized during one year study period. The mean ±SD for age and serum sodium level for whole population was 58.97±8.64 and 127.31±3.52 respectively. The treatment was initialized. The symptomatic patients were managed by IV hypertonic saline with rate and dose calculation followed by oral salt supplementation. Ten patients (19%) hyponatremic subjects expired during hospitalization whereas no any case of central pontine myelinolysis was detected in our study population. The hyponatremia was identified in 52 (59.7%) with male gender predominance 32 (61.5%). The common etiological factors detected were GI fluid loss 12 (13.8%), CVA 10 (11.5%), lungs abscess 11 (12.6%) and renal failure 10 (11.5%) respectively. The mild, moderate and severe hyponatremia was detected in 17 (32.7%), 24 (46.2%) and 11 (21.2%). CONCLUSION: Hyponatremia is fairly common in patients admitted in emergency wards
Journal of Medical Science And clinical Research, 2015
Introduction: Hyponatremia is one of the most common electrolyte disturbances of encountered in medical wards, Dialysis unit, and medical intensive care unit (ICU). It is defi ned as sodium ion concentration <135 mmol. ICU in patients with various comorbid conditions such as congestive heart failure (CHF), chronic kidney disease (CKD), liver cirrhosis, and diarrhea and vomiting. This contributes to substantial morbidity and mortality. However, early recognition and management drastically alters the prognosis. Objective: This study was conducted to explore the clinical profile of hyponatremia in medically ill patients. Materials and Methods: Study was conducted on 100 patients admitted in the medical unit from October 2011 to October 2013.All patients underwent clinical examination, routine hemogram, blood urea, sugar, creatinine, serum electrolytes and necessary investigations. Patients were divided as per their osmolarity. SIADH was diagnosed on the basis of diagnostic criteria by Verbalis. Results: The commonest age group of presentation of hyponatremia was older age group (>56 years). Hyponatremia was more common in males than in females. SIADH was the single most important etiology of hyponatremia. Diuretics and salt wasting nephropathy were also significant causes of hyponatremia in this study. Other causes of hyponatremia were CCF, Cirrhosis of liver, Hypothroidism and gastro-Intestinal loss. Among the various diuretics causing hyponatremia thiazides were the most frequent cause. Drowsiness was the single most important symptom of hyponatremia followed by vomitting, hiccups and seizures were also significant symptoms in this study. However one fifth of patients of hyponatremia had no symptoms of hyponatremia. Majority of the patients had mild hyponatremia. Majority of the patients had euvolemic hyponatremia.Mortality was more in patients with severe hyponatremia. Conclusion: Hyponatremia is fairly common in patients admitted in medical wards, ICU, dialysis unit as patients with CHF, CKD, Liver cirrhosis, and diarrhea and vomiting hence early recognition and prompt treatment are of supreme importance in such patients.
2017
Introduction: Hyponatremia is a common electrolyte abnormality in hospitalized patients. It is defined as serum sodium concentration less than 135mEq/L. It occurs due to disruption of sodium and water homeostasis. Clinical presentation varies from asymptomatic patients to ones having seizures and coma. Aims and objective: To delineate the clinical profile and causes of hyponatremia in patients admitted in a medical ward. Material and methods: This study was conducted on 100 patients admitted in medicine ward of tertiary care teaching hospital of northeast India from September 2016 to February 2017. Patients older than 18 years with serum sodium less than 135mEq/L were included in the study. Detailed history, clinical examination and all necessary investigations were done accordingly. P value <0.05 was taken as statistical significance. Results: In the present study 72% were male, and 84% of patients was older than 50 years. Out of all patients 70% were symptomatic, out of which 4...