A study of etio-pathogenesis of moderate to severe hyponatremia in patients admitted to MICU in a tertiary care hospital, Nandyal

 

 

Abstract              Background: Hyponatremia is the most common electrolyte disorder in critically ill patients and is a leading cause of morbidity and mortality. Sodium is the principal extracellular cation and the main salt of osmolality. Despite the awareness of hyponatremia for a long time, this common disorder remains an enigma. Because it is associated with a plethora of underlying disease states and multiple etiologies with different pathophysiological mechanisms. Aim: To find etiopathogenesis of moderate to severe hyponatremia in patients admitted to MICU. To assess the predominant system involvement of the study population. To assess the outcome of patients among the study group. Materials and Methods: A Hospital-based Prospective study was conducted in the Department of Medicine, Santhiram medical college and general hospital for six months period. Patients with >18 years of age with moderate to severe hyponatremia(<125meq/l) in MICU, with informed and written consent taken from the patient. Results: The male to female ratio was 1.43:1, with 58% of the patients being males. The mean age was 58.94 ± 16.10 years. Nearly half of the study group had altered sensorium (48%). The commonest system to be involved was the central nervous system (43%).50% of patients were euvolemic. 54% of the patients had severe hyponatremia, with confusion being significantly high in such patients (p<0.001). The commonest cause of hyponatremia was SIADH (46%) with infections (Tuberculosis, found in 57.7%) being the predominant cause. The majority (94%) of the patients in the study improved. Conclusion: Clinicians need to be aware of the frequent occurrence of hyponatremia, its early identification, and its association with a large variety of diseases. Patients with hyponatremia should be meticulously screened for the presence or absence of tuberculosis. A thorough understanding of the pathophysiological process of hyponatremia and its associated risk factor is of great importance in prompt and effective treatment.

Key Word: hyponatremia.