Title: Clinico-Etiological Profile of Hyponatremia in Patients Admitted in Intensive Care Unit of Tertiary Health Care Rural Center
Authors: Dr. Manish Patni, Dr. N.R. Humaney, Dr. Jitesh Jeswani, Dr. S.A. Deoke
DOI: http://dx.doi.org/10.18535/jmscr/v3i8.12
DIDS : 08.2015-34846767
Abstract
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.
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