MEM Cast Episode 225: Hyponatraemia part 1
Sep 13, 2024
Dr. Abilash Sathyanarayanan, an endocrine senior registrar at Queen's Medical Centre, specializes in electrolyte abnormalities, particularly hyponatraemia. In this engaging discussion, he clarifies the definition of hyponatraemia and its clinical significance. He dives into the critical imbalance of water and sodium, explaining both ADH-dependent and independent causes. Dr. Abilash also highlights medications that can trigger hyponatraemia, offering practical insights on distinguishing between acute and chronic cases, all framed within a diagnostic approach for better patient management.
AI Snips
Chapters
Transcript
Episode notes
Definition And Clinical Importance
- Hyponatraemia is defined as serum sodium below the local lab reference, commonly ≤135 mmol/L.
- It is common and linked to both acute dangers like cerebral edema and chronic subtle harms and worse outcomes.
Think Water Not Sodium
- Hyponatraemia is usually a water problem rather than a sodium problem, caused by excess water relative to sodium.
- Causes include pure water excess (e.g., primary polydipsia) or losses that remove more sodium than water.
Use An ADH-Based Diagnostic Framework
- Use an ADH-dependent versus ADH-independent framework to classify causes of hyponatraemia.
- This helps separate conditions with inappropriate ADH (e.g., SIADH) from pure water excess states like primary polydipsia.