Thomas Antony1, Nayyar Iqbal2, Sudhagar Mookkappan3, Aneesh Basheer4, Govindrajan Dhandapani5
Hyponatraemia is one of the commonest electrolyte abnormalities among admitted patients. It is also the commonest electrolyte abnormality associated with morbidity and mortality. Hence, we aimed to study the clinical and aetiological profile of patients admitted with severe hyponatraemia in Pondicherry Institute of Medical Sciences, Pondicherry.
MATERIALS AND METHODS
A prospective observational study conducted at tertiary care hospital in South India during last 18 months. All patients above age of 18 presenting with serum sodium less than or equal to 125 mEq/L were included in the study. Detailed medical and surgical history was recorded. Routine investigation like complete haemogram, renal function test, serum electrolytes, thyroid function test, serum cortisol and urine spot sodium and osmolality were done. Descriptive variables were expressed in mean and standard deviations. They were compared using Mann-Whitney U test and x2 test.
89 patients presented with serum sodium of less than 135 mEq/L out of which 50 patients had serum sodium level of less than 125 mEq/L. The patients with serum sodium level of less than 125 mEq/L were included in the study. 56% were males and 44% were females. More than 50% of the patients were above the age of 60. Mean sodium level at admission was 115 mEq/L. 64% of the patients were euvolaemic at admission while 24% were hypervolaemic. Syndrome of Inappropriate Antidiuretic Hormone (SIADH) was the commonest cause for hyponatraemia (18%) and thiazide diuretics use was the second most common cause (12%). One death due to hyponatraemia was recorded during our study. There was no association of severity of hyponatraemia and symptoms (p >0.05).
Hyponatraemia is common among elderly. SIADH is the commonest cause for hyponatraemia among the admitted patients. Chronic hyponatraemia may have a weak association with serum sodium and symptoms.
Severe Hyponatraemia, Elderly, Syndrome of Inappropriate Antidiuretic Hormone.