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.