Hyponatremia is a common electrolyte disorder defined as a serum sodium
level of less than 135 mEq per L is the most common disorder of body
fluid and electrolyte balance encounte-red in clinical practice.
It
is associated with increased mortality, morbidity and length of
hospital stay in patients presenting with a range of
conditions. Hyponatremia is therefore both common and important.
Hyponatremia
results from the inability of the kidney to excrete a water load or
excess water intake. Water intake depends upon thirst mechanism. Thirst
is stimulated by increase in osmolality.
Thirst is sensed by
osmoreceptors located in the hypothalamus and leads to the release of
anti-diuretic hormone (vasopressin) from the posterior pituitary.
Anti-diuretic hormone acts on the V2 receptors located at the
basolateral aspect of the collecting duct cells and leads to increased
aquaporin expression on the luminal aspect of the collecting duct cells
which increases water absorption and abolishes thirst.
The most
common causes of hyponatremia are the syndrome of inappropriate
anti-diuresis (SIAD), diuretic use, polydipsia, adrenal insufficiency,
hypovolemia, heart failure, and liver cirrhosis (the latter two are
often collectively referred to as “hypervolemic hyponatremia”).
The most common classification system for hyponatremia is based on volume status:
*hypovolemic (decreased total body water with greater decrease in sodium level)
*euvolemic (increased total body water with normal sodium level)
*hypervolemic (increased total body water compared with sodium)
Hyponatremia – serum sodium concentration less than normal
Nutrition is a scientific discipline that encompasses a structured body of knowledge. It includes various fields such as clinical nutrition, community nutrition, public health, food policy, and food science. At its core, nutrition is the study of how the body utilizes food. It is essential to life. Understanding nutrition enables us to make better dietary choices by determining the necessary nutrient intake, identifying optimal food sources, and recognizing beneficial or harmful food components.
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