Morbidity Associated with Chronic Hyponatremia

Abstract

This article will discuss the consequences of chronic hyponatremia. In conditions such as cancer, heart failure, liver cirrhosis, or chronic kidney disease, the presence and magnitude of hypotonic hyponatremia are considered to reflect the severity of the underlying disease and are associated with increased morbidity as well as mortality. Hyponatremia can be acute (< 48 h) or chronic (> 2–3 days). Chronic hyponatremia is associated with attention deficit, dizziness, tiredness, gait disturbance, falls, sarcopenia, bone fractures, osteoporosis, hypercalciuria (in the syndrome of inappropriate antidiuresis—SIADH), and kidney stones. In vitro studies have shown that cells grown in a low concentration of extracellular sodium have a greater proliferation rate and motility. Patients with chronic hyponatremia are more likely to develop cancer. We will not review the clinical consequences of respiratory arrest and osmotic demyelination syndrome (ODS) of the too-late or excessive treatment of hyponatremia.

Associations between Baseline Hyponatremia and Activities of Daily Living and Muscle Health in Convalescent Stroke Patients

“…In unadjusted two-group comparisons, patients with hyponatremia showed significantly lower scores for FIM-motor at discharge (44 [15,78] vs. 81 [55, 89], P<0.001) and its gain during hospitalization (15 [2,35] vs. 21 [10,34], P=0.044). Moreover, although SMI at discharge was not significantly different between the two groups, HGS at discharge was significantly lower in patients with hyponatremia compared to those without hyponatremia (17.6 [12.7, 23.9] kg vs. 21.5 [13.9, 30.2] kg, P<0.001) (Table 2).…”

“…Hyponatremia can affect neurological function, causing cognitive dysfunction and muscle weakness. 35 ) It is also associated with peripheral nervous system dysfunction, 36 , 37 ) cellular swelling affecting muscle cells, 36 ) and cardiovascular changes affecting grip strength because of effects on blood flow and microcirculation. 38 ) Further research is required to comprehend these mechanisms and move toward targeted treatment strategies, noting that hospital-associated sarcopenia is closely associated with adverse clinical outcomes, including physical function and ADL.…”

Updates in hyponatremia and hypernatremia

“…Patients with chronic hyponatremia are therefore traditionally thought to be asymptomatic or have milder symptoms such as restlessness, irritability, weakness, and fatigue. However, recent studies in the adult population have shown that chronic hyponatremia is associated with cognitive impairment, gait instability, osteoporosis, and fractures and contributes to increased morbidity [25,26,27 ▪ ]. The association of chronic hyponatremia as a potential risk factor for decreased bone density has been reported in adolescents with anorexia nervosa [28], and additional studies of the impact of chronic hyponatremia on bone health in the pediatric population are needed.…”

Thalamic Neuron Resilience during Osmotic Demyelination Syndrome (ODS) Is Revealed by Primary Cilium Outgrowth and ADP-ribosylation factor-like protein 13B Labeling in Axon Initial Segment

“…In the neonatal and pediatric units, about 2.5% of emergency care ODS patients can die from it [6,45,80,[97][98][99][100][101][102][103][104][105][106][107][108][109][110][111][112]. Another survey of emergency admissions to hospital showed hyponatremia can occur in 15-20% of critically ill patients [113,114]. The same proportion can be reported for the confined, aged population [115][116][117][118][119][120], where hyponatremia could cause or result in motility-related disabilities (such health incidents could be preventable) because deficits in homeostatic sodium gradient along with mental disorders can cause patient's confusion, disorientation, paresis-including fracture susceptibility- [85,114,116,[120][121][122][123].…”

“…Another survey of emergency admissions to hospital showed hyponatremia can occur in 15-20% of critically ill patients [113,114]. The same proportion can be reported for the confined, aged population [115][116][117][118][119][120], where hyponatremia could cause or result in motility-related disabilities (such health incidents could be preventable) because deficits in homeostatic sodium gradient along with mental disorders can cause patient's confusion, disorientation, paresis-including fracture susceptibility- [85,114,116,[120][121][122][123]. In other cases, deafness, memory loss to seizure, unresponsiveness and eventually coma have occurred, e.g., [21,28,50,124].…”