Sunayana Sahebrao Lomte1, P. D. Jalgaonkar2, Sunil Kumar3, Shreerang Kishor Bhurchandi4

Hyponatraemia is the most common electrolyte disorder among hospitalised patients occurring in upto 22% of hospitalised patients.1 David B Mount defined hyponatraemia as a serum sodium concentration (Na+) less than 135 mEq/L. The aim of this study is to describe the clinical profile of hyponatraemia in patients admitted to Acharya Vinoba Bhave Rural Hospital, Sawangi, Wardha. There is limited information about the clinical profile of hyponatraemia in rural areas.
This prospective observational hospital-based study was conducted from September 2014-August 2016 at AVBRH, Sawangi, Wardha. A total of 100 cases with serum sodium level <135 mEq/L were studied. History and clinical examinations were recorded in all patients. Necessary laboratory and radiological investigations were done.
The incidence of hyponatraemia in our study was 7.2 percent 60 cases were males and 40 cases were females. Hyponatraemia was commonly observed in the age group of 51-70 years in both the groups. 31 patients were mild hyponatraemia, 55 patients were moderate hyponatraemia, 14 patients were severe hyponatraemia, 55 patients had euvolaemia, 24 patients had hypovolaemia and 21 patients had hypervolaemia. Euvolaemic moderate-grade hyponatraemia was most commonly observed 26 cases (26%). The most common clinical features were altered sensorium (46%) and hypertension (36%). Both were common in severe hyponatraemia. Euvolaemic hyponatraemia (55 patients) was most common in our study. Further SIADH was the most common diagnosis among this group of patients. The most common aetiology was cerebrovascular episode (38%). The mortality was found to be 10% in this study. The mortality was found to be higher in euvolaemic hyponatraemia (12.72%).
Hyponatraemia was more common in the elderly age group. Among neurological causes, cerebrovascular episode was the commonest. Most of the patients in the study were found to have euvolaemic hyponatraemia (55%). SIADH was the commonest cause of hyponatraemia in our study. The mortality was higher in euvolaemic hyponatraemia. We also conclude that all the patients with altered sensorium should be evaluated for hyponatraemia even when they have underlying neurological disease. Treatment of comorbid disease in case of hyponatraemia is equally important.