Remember to check plasma osmolality first!
Next evaluate volume status!
If a patient is Euvolemic – evaluate urine osmolality and sodium
Practical approach to hyponatremia:
1.What is the normal/abnormal physiology?
2.Is it “true” hypo-osmolar hyponatremia?
- Measure plasma osmolality
3.What is the volume and ADH status?
- Urine Na and Urine Osmolality
4.Is it symptomatic?
5.What is my treatment?
- Depends on volume status, ADH status, and +/- symptoms
- Determine goal of correction
- Avoid overcorrection