Clinical profile of patients of hyponatremia in a tertiary care centre

Background: The prompt recognition of hyponatremia in hospitalized patients may reduce in-hospital mortality and symptom severity, allow for less intensive hospital care, decrease the duration of hospitalization and associated costs, and improve the treatment of underlying co morbid conditions and patients’ quality of life. Methods: The patients admitted in medical wards, aged > 18 years with serum sodium levels less than 135 mEq/L were included in the study. Results: Out of 120 patients there were 83 (69%) males. Altered sensorium 43 (35.8%), shortness of breath 30 (25%), vomiting 20 (16.7%), fatigue 18 (15%) and dizziness 14 (11.7%), headache (6.7%), seizures (6.7%) and anorexia (6.7%) were main symptoms at presentation to hospital. The euvolemic hyponatremia was most common in 65 (54.2%), followed by hepervolemic in 41 (34.2%) andhypovolemic in 14(11.7%) patients. 66 (55%) patients had moderately severe, 42 (35%) had severe hyponatremia and 12 (10%) cases were of mild severity of hyponatremia. Kidney disease, 33 (27.5%), diabetes mellitus 28 (23.3%), recurrent vomiting (16.7%), drug induced (12.5%) and alcohol induced (8.3%) were main underlying etiologies associated with hyponatremia. Conclusion: In this study of hyponatremia in hospitalized patients, about one third patients presented with altered sensorium and seizure and anorexia were noted only in minority. The majority of patients had moderately severe and severe hyponatremia. The euvolemic hyponatremia was noted in more than half of patients of hyponatremia. The kidney diseases, diabetes mellitus and hypothyroidism were main co-associated morbidities in the study group. The thiazide diuretic was most common diuretic culprit for drug induced hyponatremia.