author={Daniel A. Henry},
  journal={Annals of Internal Medicine},
  • D. Henry
  • Published 2015
  • Medicine
  • Annals of Internal Medicine
Hyponatremia is the most common electrolyte disorder in hospitalized patients. Hospital-associated hyponatremia includes admission hyponatremia (community-acquired hyponatremia) and hospital-acquired hyponatremia. The reported incidence of hospital-associated hyponatremia ranges between 10% and 30%, depending on the definition, patient population, and case mix. It is associated with increased mortality, hospital length of stay, hospital costs, intensive care unit (ICU) days, and chance of… 

[Hyponatremia: Differential Diagnosis and Treatment].

The purpose of this review is to provide the reader with a systematic approach to the correct diagnosis and management of hyponatremia based on available European and international guidelines.

Diagnosis and Management of Hyponatremia: A Review.

US and European guidelines recommend treating severely symptomatic hyponatremia with bolus hypertonic saline to reverse hypon atremic encephalopathy by increasing the serum sodium level by 4 mEq/L to 6 mEqu/L within 1 to 2 hours but by no more than 10 mEQ/L (correction limit) within the first 24 hours.

[Hyponatremia: differential diagnosis and therapy].

A differential diagnostic approach using a simple algorithm that includes clinical and laboratory parameters is essential for identifying the underlying cause of hyponatremia and administering goal-directed therapy.

Clinical Implications, Evaluation, and Management of Hyponatremia in Cirrhosis.

Acute and Chronic Hyponatremia

Proper knowledge of sodium and water homeostasis is essential in individualizing therapeutic plans and avoid iatrogenic complications while managing this disorder.

Acute Water Intoxication With Resultant Hypo-Osmolar Hyponatremia Complicated by Hypotension Secondary to Diffuse Third-Spacing

Key diagnostic and treatment elements of this potentially life-threatening disease are discussed to encourage clinicians to utilize social history when evaluating cases of acute water intoxication and resultant symptomatic hypotonic hyponatremia.

[Difficulties in the differential diagnosis of hyponatremia presenting with severe neuropsychiatric symptoms].

The authors aimed to shed light on the often insurmountable difficulties of the diagnosis, differential diagnosis and appropriate treatment of this very frequent electrolyte imbalance by presenting a clinical case report.


This review summarises the main aspects regarding the use of tolvaptan and conivaptan, which are the only vaptans currently available in clinical practice, and defines safe treatment strategies for hyponatraemia.

Fluid Replacement Versus Fluid Restriction in COVID-19 Associated Hyponatremia

A case of hypovolemic hyponatremia in a patient with COVID-19, which unlike SIADH, required fluid replacement early in the disease course for its correction, is presented.