How is hypervolemic hyponatremia diagnosed?
How is hypervolemic hyponatremia diagnosed?
A trial of volume expansion with isotonic saline can be used to diagnose hypovolemic hyponatremia. Although a rise in SNa in response to isotonic saline would be consistent with hypovolemic hyponatremia, another possibility would be that the stimulus for vasopressin release in a patient with SIAD abated.
What are the 2 types of hyponatremia?
Hypovolemic hyponatremia: decrease in total body water with greater decrease in total body sodium. Euvolemic hyponatremia: normal body sodium with increase in total body water. Hypervolemic hyponatremia: increase in total body sodium with greater increase in total body water.
Are there any clinical symptoms associated with hyponatremia?
For many people, therefore, the recognition is entirely incidental. Patients may develop clinical symptoms due to the cause of hyponatremia or the hyponatremia itself. Many medical illnesses, such as chronic heart failure, liver failure, renal failure, or pneumonia, may be associated with hyponatremia.
How to treat normovolemic hyponatremia due to SIADH?
Physiologic considerations indicate that a relatively small increase in the serum Na concentration, on the order of 5%, should substantially reduce cerebral edema. Treatment of normovolemic hyponatremia due to SIADH can include fluid restriction and the administration of normal saline.
How is conivaptan used in the treatment of hyponatremia?
Conivaptan, a V1A and V2 vasopressin receptor antagonist, is available only for intravenous use and is approved for use in the hospital setting for euvolemic and hypervolemic hyponatremia. It is contraindicated in hypovolemic patients. It induces both a water and sodium diuresis with improvement in plasma sodium levels.
Can a venous pressure gradient predict hyponatremia?
[Medline]. Kim MY, Baik SK, Yea CJ, et al. Hepatic venous pressure gradient can predict the development of hepatocellular carcinoma and hyponatremia in decompensated alcoholic cirrhosis. Eur J Gastroenterol Hepatol. 2009 Nov. 21 (11):1241-6.