Hospitalized patients at risk if sodium levels are low

by Emily Barker, Frontiersin.org

Hospitalized ‪patients could be at risk of weak ‪‎bones‬ and increased infections if physicians ignore signs of low-sodium in the body, known as hyponatremia.

Scientists knew that hyponatremia caused swelling in the brain, however new research shows that the condition is actually systemic and affects all of the body.

Hyponatremia can demineralize the bones causing osteopenia – weak bones – leading to increased risk of falls and fractures, it can also lead to greater risk of infection and cause sepsis. This is particularly dangerous for elderly patients.

The sodium in the body is very tightly regulated in a very narrow range, certain illnesses can mean the body is unable to get rid of water properly causing the sodium level to get low.   

“When that happens water moves from outside of the cells to inside of the cells, but we are finding that low blood sodium alters cellular function so that cells do not function properly;” explained Dr. Michael Moritz, Field Chief Editor for Frontiers in Pediatrics, and Associate Editor for Nephrology in Frontiers in Medicine.

Patients who are acutely ill have high vasopressin, which decreases their ability to get rid of water, increasing the risk of hyponatremia.

Dr. Moritz admitted: “Most physicians will think this is innocuous, that having a sodium that is a bit low doesn’t matter, but what we’re finding out is once you’re hyponatremic at all, your morbidity starts increasing.”

“Any physician who has a patient admitted needs to be vigilant about hyponatremia and they have to view free water as a potentially toxic medication. Free water needs to be limited and when the sodium gets low they need to take corrective actions to correct the hyponatremia;” he explained.

Around 15% to 30% of patients who step into a hospital will be hyponatremic.

“One thing we have observed is if a patient who is hospitalized only received isotonic fluids that has a sodium concentrate the same as the plasma the incidents of hyponatremia goes down from about 30% to about 5%;” added Dr. Moritz.

He explained that despite this a lot more work needs to be done to prevent hyponatremia.

Dr. Moritz serves as Clinical Director of Pediatric Nephrology at the Children’s Hospital of Pittsburgh of the University of Pittsburgh Medical Center (UPMC), and as Professor of Pediatrics at the University of Pittsburgh School of Medicine. Dr. Moritz is an authority on sodium and water metabolism in children.

Further author biography and related research articles available via Loop.

 

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