Clinico-etiological profile of hyponatremia among elderly patients admitted in medical ward of rural tertiary care hospital Dr.RPGMC Kangra at Tanda Himachal Pradesh.

Authors

  • Manju . Assistant Professor Department of Medicine Dr.RPGMC, Tanda, H.P.
  • Dhiraj Kapoor Professor and HOD Department of Medicine Dr.RPGMC, Tanda, H.P.
  • V.D Dogra Associate Professor, Department of Medicine, Dr.RPGMC, Tanda, H.P.
  • Gopal Singh Senior Resident Department of Anaesthesia, Dr.RPGMC Tanda H.P.

Keywords:

Hyponatremia; Syndrome of Inappropriate Ant-diuretic hormone; Altered Sensorium.

Abstract

Background: Hyponatremia, defined as a serum sodium concentration <135 mmol/l. It may be asymptomatic or present with symptoms ranging from nausea, lethargy to seizure and coma or even life threatening. Timely diagnosis can result in appropriate interventions to reduce these symptoms and mortalities.  Aims and Objective: To study the incidence, etiology, clinical features and treatment outcomes of hyponatremia at a tertiary care centre.

Material and Methods: Study was conducted at a Rural tertiary care centre DRPGMC Kangra at Tanda, H.P, from the period 01 August 2019 to 01 August 2020. Present study was observational study.  Elderly Patient with serum Na+≤135 meq/l were included in study. Based on history and clinical examination patients were classified as hypovolemic hyponatremia, hypervolemic hyponatremia and euvolemic hyponatremia. Patients with clinical euvolemia, Urine Na+>20 mmol/l, Serum uric acid ≤4 mg/dl, normal renal function (serum creatinine and blood urea) and absence of thyroid or pituitary insufficiency were classified as having Syndrome of inappropriate antidiuresis (SIADH). The sodium estimation was done in the randox automated analyser which measures sodium by ion selective electrode technology. Result:  Total of 100 patients with hyponatremia (serum sodium chloride < 135mEq/L) .Mean age of the patients was 73.87 ± 6.54 years with a male to female ratio of 1.04:1.  About 82% of patients were symptomatic among which lethargy (50%), drowsiness (42%), and abnormal behavior (35%) were common symptoms. Most patients (49%) had profound hyponatremia and Syndrome of inappropriate anti-diuretic hormone secretion (SIADH) (39%) and drugs (26%) were the most common cause of hyponatremia in this study. The common treatment given in this study was 0.9% NaCl (68%) and 3% NaCl and Mortality of patients in this study was 17%. Conclusion: Commonest age group for hyponatremia was 70–74 years. Majority of the patients fell in euvolemic group followed by hypervolemic. Most common presentation of hyponatremia was altered sensorium, lethargy; vomiting and one patient had seizure. The possible cause of hyponatremia should always be sought as outcome in severe hyponatremia is governed by etiology, and not by the serum sodium level. Treatment of severe symptomatic hyponatremia with hypertonic saline is safe if recommendation for the rate of correction of hyponatremia is strictly followed.

Key words: Hyponatremia; Syndrome of Inappropriate Ant-diuretic hormone; Altered Sensorium.

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Published

2020-11-08

How to Cite

., M., Kapoor, D., Dogra, V., & Singh, G. (2020). Clinico-etiological profile of hyponatremia among elderly patients admitted in medical ward of rural tertiary care hospital Dr.RPGMC Kangra at Tanda Himachal Pradesh. International Journal of Health and Clinical Research, 3(9), 221–226. Retrieved from https://ijhcr.com/index.php/ijhcr/article/view/430