Hyponatremia ; body water > body Na content , associated with hypo-osmolarlity
definition ; s-Na concentration ≤ 130mEq/l
3-6 % of hospitalized patients
1. First task
; truly hypo-osmolar state? Vs.
translocational hyponatreamia or pseudohyponatremia?
2. Next step
; assess volume status by clinical examination
hypovolemic vs. euvolemic vs. hypervolemic
Total body Na deficit > total body water deficit
free water, hypotonic fluids의 excess intake → large loss of water and solute through the renal or GI route
circulating blood vol. 감소 → nonosmotic release of ADH → retention of free water,