Incidencia de la hiponatremia y de sus causas en pacientes neurológicos / Incidence of hyponatremia and its causes in neurological patients

Introducción La hiponatremia se considera el trastorno electrolítico más frecuentemente hallado entre pacientes hospitalizados y parece ser un factor pronóstico en dicha hospitalización. Métodos Se realizó un estudio prospectivo observacional en pacientes ingresados de forma consecutiva en el Hospital del Mar de Barcelona, durante un período de 3 meses. Se realizó un ionograma en sangre y orina, así como la osmolalidad en plasma y orina, al ingreso y tras 3–5 días en aquellos que presentaban hiponatremia. Resultados De los 130 pacientes incluidos, 19 (14,6%) presentaron hiponatremia. Las causas de hiponatremia fueron las siguientes: administración de sueros hipotónicos, 4 (21%); medicación antihipertensiva, 4 (21%); síndrome de secreción inadecuada de hormona antidiurética, 4 (21%); síndrome pierde sal cerebral, 2 (10%); estado edematoso causado por hepatopatía, uno (5%), pérdidas digestivas, 2 (10%), cardiopatia hipertensiva, 1 (5%) y 1 paciente sin diagnóstico etiológico (5%). La mortalidad fue de uno (5%) y 0 (0%) entre los pacientes con y sin hiponatremia, respectivamente. Conclusión La hiponatremia es un trastorno común entre pacientes neurológicos hospitalizados, y la falta de diagnóstico podría ser interpretada como un empeoramiento del cuadro neurológico (AU)

Introduction Hyponatremia is considered the most frequent electrolyte disorder found in hospitalized patients and seems to be a prognostic factor during hospitalization. Methods A prospective observational study was carried out in consecutive neurological patients admitted to our hospital over a 3-month period. Blood and urinary ionogram and osmolality were determined at entry and 3–5 days after admission in all patients with hyponatremia. Results Of the 130 patients admitted, 19 (14.6%) had hyponatremia. The causes of hyponatremia were as follows: inappropriate fluid replacement in 4 patients (21%), antihypertensive drugs in 4 (21%), syndrome of inappropriate secretion of antidiuretic hormone in 4 (21%), cerebral salt wasting syndrome in 2 (10%), and edematous status caused by liver disease in one and digestive loss in one (5%) each. Mortality was one (5%) and 0 (0%) among patients with and without hyponatremia, respectively.Conclusion Hyponatremia is common in hospitalized neurological patients and can be misdiagnosed as a worsening of the main illness (AU)

[Incidence of hyponatremia and its causes in neurological patients]. / Incidencia de la hiponatremia y de sus causas en pacientes neurológicos.

INTRODUCTION: Hyponatremia is considered the most frequent electrolyte disorder found in hospitalized patients and seems to be a prognostic factor during hospitalization. METHODS: A prospective observational study was carried out in consecutive neurological patients admitted to our hospital over a 3-month period. Blood and urinary ionogram and osmolality were determined at entry and 3-5 days after admission in all patients with hyponatremia. RESULTS: Of the 130 patients admitted, 19 (14.6%) had hyponatremia. The causes of hyponatremia were as follows: inappropriate fluid replacement in 4 patients (21%), antihypertensive drugs in 4 (21%), syndrome of inappropriate secretion of antidiuretic hormone in 4 (21%), cerebral salt wasting syndrome in 2 (10%), and edematous status caused by liver disease in one and digestive loss in one (5%) each. Mortality was one (5%) and 0 (0%) among patients with and without hyponatremia, respectively. CONCLUSION: Hyponatremia is common in hospitalized neurological patients and can be misdiagnosed as a worsening of the main illness.