Hiponatremia
Epidemiologia

Hiponatremia, definiowana jako stężenie sodu w surowicy poniżej 135 mmol/L, jest najczęstszym zaburzeniem elektrolitowym o częstości występowania 1,7-1,9% w populacji ogólnej i 15-35% wśród pacjentów hospitalizowanych, z ciężką hiponatremią (<125 mmol/L) dotyczącą 1-4% chorych szpitalnych. Szczególnie wysoka częstość (do 40%) obserwowana jest na oddziałach intensywnej terapii, a także u pacjentów z marskością wątroby (50%), niewydolnością serca (27%) oraz w podeszłym wieku (około 30%). Hiponatremia jest częsta także u pacjentów leczonych diuretykami tiazydowymi (30-39%) i lekami psychotropowymi (SSRI 0,5-32%). W populacji pediatrycznej umiarkowana i ciężka hiponatremia występuje u około 1% hospitalizowanych dzieci, a łagodna u 45% dzieci z pozaszpitalnym zapaleniem płuc. Hiponatremia wysiłkowa ma częstość około 7-8 przypadków na 100 000 osobolat, z wahaniami w czasie.

  1. Epidemiologia hiponatremii
    1. Częstotliwość występowania w populacji ogólnej
    2. Hiponatremia w warunkach szpitalnych
    3. Hiponatremia w specyficznych populacjach
    4. Epidemiologia hiponatremii u dzieci
    5. Hiponatremia wysiłkowa
    6. Czynniki ryzyka hiponatremii
  2. Wpływ hiponatremii na rokowanie
    1. Śmiertelność
    2. Wpływ na długość hospitalizacji i wykorzystanie zasobów
    3. Hiponatremia w COVID-19
  3. Nadzór i monitoring hiponatremii
  4. Podsumowanie badań epidemiologicznych
    1. Kolejne rozdziały

Epidemiologia hiponatremii

Hiponatremia, definiowana jako stężenie sodu w surowicy poniżej 135 mmol/L, jest najczęściej występującym zaburzeniem elektrolitowym zarówno wśród pacjentów hospitalizowanych, jak i w populacji ogólnej. Częstość jej występowania jest zróżnicowana w zależności od badanej populacji, przyjętych kryteriów diagnostycznych oraz nasilenia zaburzenia.123

Częstotliwość występowania w populacji ogólnej

W populacji ogólnej Stanów Zjednoczonych ważona częstość występowania hiponatremii wynosi około 1,72% (1,89% po uwzględnieniu przypadków hiponatremii rozcieńczeniowej). Badania National Health and Nutrition Examination Survey wykazały, że stężenie sodu w populacji ma rozkład normalny ze średnią wartością 139 mmol/L (odchylenie standardowe 1,94 mmol/L).45 Częstość występowania hiponatremii w społeczności osób w wieku podeszłym znacząco wzrasta do około 8%.6

Występowanie hiponatremii koreluje z obecnością chorób współistniejących – jej częstość jest wyższa u osób z nadciśnieniem tętniczym, cukrzycą, chorobą wieńcową, po udarze mózgu, przewlekłą obturacyjną chorobą płuc (POChP), chorobami nowotworowymi oraz zaburzeniami psychicznymi. Wśród osób bez chorób współistniejących częstość hiponatremii jest niższa i wynosi około 1,04%.7

Hiponatremia w warunkach szpitalnych

Częstość występowania hiponatremii jest znacznie wyższa wśród pacjentów hospitalizowanych i wynosi od 15% do 35%. Występowanie ciężkiej hiponatremii (stężenie sodu poniżej 125 mmol/L) dotyczy około 1-4% pacjentów szpitalnych.8910

Szczególnie wysoką częstość hiponatremii obserwuje się wśród pacjentów oddziałów intensywnej terapii, gdzie może dotyczyć nawet 40% chorych. Jest to związane z ciężkim stanem klinicznym, współistnieniem wielu chorób oraz stosowaniem licznych leków mogących wpływać na gospodarkę wodno-elektrolitową.1112

Wśród pacjentów pooperacyjnych hiponatremia rozwija się u około 4,4% chorych w pierwszym tygodniu po zabiegu.13 U pacjentów ambulatoryjnych częstość hiponatremii jest niższa niż u hospitalizowanych i wynosi około 7,7%.14

Hiponatremia w specyficznych populacjach

Występowanie hiponatremii różni się znacząco w zależności od współistniejących chorób i stanów klinicznych:

  • U pacjentów z niewydolnością serca hiponatremia występuje u około 27% chorych15
  • Wśród pacjentów z marskością wątroby i wodobrzuszem hiponatremia występuje u około 50% chorych1617
  • U pacjentów przyjmowanych do szpitala z powodu zapalenia płuc nabytego w środowisku pozaszpitalnym, hiponatremia występuje u około 25% chorych18
  • U osób w podeszłym wieku przebywających w domach opieki hiponatremia występuje u około 30% pensjonariuszy19
  • Wśród pacjentów z depresją leczonych selektywnymi inhibitorami wychwytu zwrotnego serotoniny (SSRI) hiponatremia występuje u około 30% chorych20, przy czym częstość hiponatremii wywołanej przez SSRI waha się od 0,5% do 32%21
  • Około 4% pacjentów z przewlekłą schizofrenią rozwija hiponatremię22
  • U pacjentów z dializą otrzewnową częstość hiponatremii wynosi około 14,5%23, a wśród pacjentów z zapaleniem otrzewnej związanym z dializą otrzewnową hiponatremia występuje u około 27% chorych24

Epidemiologia hiponatremii u dzieci

W populacji pediatrycznej częstość występowania umiarkowanej i ciężkiej hiponatremii (stężenie sodu ≤130 mmol/L) wśród hospitalizowanych dzieci wynosi około 1%. Natomiast łagodna hiponatremia (stężenie sodu ≤135 mmol/L) występuje nawet u 45% dzieci przyjmowanych do szpitala z powodu pozaszpitalnego zapalenia płuc.25

U skrajnie wcześnie urodzonych niemowląt wczesna hiponatremia występuje bardzo często – w jednym z badań częstość wynosiła aż 79%.26

Hiponatremia wysiłkowa

Szczególną formą hiponatremii jest hiponatremia wysiłkowa (ang. exertional hyponatremia), która występuje podczas lub po intensywnym wysiłku fizycznym. W badaniu przeprowadzonym wśród amerykańskich żołnierzy w latach 2003-2018 zdiagnozowano 1579 przypadków hiponatremii wysiłkowej, co daje częstość występowania 7,2 przypadków na 100 000 osobolat.27 W nowszym badaniu obejmującym lata 2008-2023 zidentyfikowano 1812 przypadków hiponatremii wysiłkowej wśród żołnierzy w czynnej służbie, co przekłada się na częstość 8,3 przypadków na 100 000 osobolat.28

Roczne wskaźniki zachorowalności na hiponatremię wysiłkową osiągnęły szczyt w 2010 roku (12,8 na 100 000 osobolat), następnie spadły do najniższego poziomu 5,3 przypadków na 100 000 osobolat w 2013 roku. W ostatnich latach obserwuje się ponowny wzrost częstości występowania do 11,7 przypadków na 100 000 osobolat w 2023 roku.29

Czynniki ryzyka hiponatremii

Zidentyfikowano szereg czynników zwiększających ryzyko wystąpienia hiponatremii:

Wiek

Wiek powyżej 30 lat wiąże się ze zwiększoną częstością występowania hiponatremii, zwłaszcza hiponatremii szpitalnej. Zależność ta nasila się wraz ze wzrostem wieku i ciężkością hiponatremii.30 Osoby w podeszłym wieku są szczególnie predysponowane do rozwoju hiponatremii ze względu na wyższą częstość występowania chorób współistniejących (np. niewydolność serca, wątroby lub nerek) oraz stosowanie wielu leków.3132

Płeć

Hiponatremia występuje częściej u kobiet niż u mężczyzn (2,1% vs 1,3%, p=0,0044).33 Płeć żeńska jest uznawana za czynnik ryzyka hiponatremii wywołanej przez leki psychotropowe i diuretyki.34 Ciężka hiponatremia występuje częściej u kobiet, co może być związane z mniejszą masą ciała.35 Ponadto objawy hiponatremii częściej występują u młodych kobiet niż u mężczyzn.36

Masa ciała

U osób starszych niska masa ciała wiąże się ze zwiększonym ryzykiem hiponatremii wywołanej przez leki.37

Leki

Stosowanie diuretyków tiazydowych znacząco zwiększa ryzyko hiponatremii. W badaniu retrospektywnym oceniającym ryzyko hiponatremii u pacjentów z nadciśnieniem tętniczym, hiponatremia wystąpiła u 30% pacjentów stosujących diuretyki tiazydowe.38 W innym badaniu częstość hiponatremii wynosiła 37,3% w grupie pacjentów stosujących indapamid i 38,7% wśród osób stosujących hydrochlorotiazyd.39

Wśród leków przeciwpadaczkowych najwyższą częstość hiponatremii obserwowano u pacjentów stosujących okskarbazepinę (1,661% leczonych) i karbamazepinę (0,169%), a następnie u pacjentów przyjmujących selektywne inhibitory wychwytu zwrotnego serotoniny i noradrenaliny (SNRI, 0,088%) oraz selektywne inhibitory wychwytu zwrotnego serotoniny (SSRI, 0,071%).40

Wpływ hiponatremii na rokowanie

Hiponatremia jest niezależnym czynnikiem ryzyka niekorzystnych wyników leczenia i zwiększonej śmiertelności zarówno wśród pacjentów hospitalizowanych, jak i w populacji ogólnej.4142

Śmiertelność

W kohorcie pacjentów z populacji ogólnej śmiertelność ogólna w okresie 1999-2006 wynosiła 11% u osób z hiponatremią w porównaniu do 4% u osób z normonatremią (nieskorygowany względny współczynnik ryzyka 3,61). Po uwzględnieniu wieku i płci, związek hiponatremii z umieralnością z wszystkich przyczyn nieznacznie osłabł (HR 2,24, p=0,001), ale ryzyko zgonu pozostało istotnie podwyższone u osób z hiponatremią nawet po dodatkowym uwzględnieniu chorób współistniejących, pochodzenia etnicznego, statusu ubezpieczenia i palenia tytoniu (HR 2,43; p<0,001).43

Ciężka hiponatremia (stężenie sodu ≤125 mmol/L) wiąże się z wysoką śmiertelnością. U pacjentów, u których stężenie sodu w surowicy spada poniżej 105 mmol/L, szczególnie u osób z zaburzeniami związanymi z używaniem alkoholu, śmiertelność przekracza 50%.44

Hiponatremia ma szczególnie niekorzystny wpływ na rokowanie w określonych stanach klinicznych:

  • U pacjentów z ostrym zawałem mięśnia sercowego z uniesieniem odcinka ST obecność hiponatremii przy przyjęciu lub wczesny rozwój hiponatremii jest niezależnym predyktorem 30-dniowej śmiertelności, a rokowanie pogarsza się wraz z nasileniem hiponatremii45
  • U pacjentów z marskością wątroby z przetrwałym wodobrzuszem i niskim stężeniem sodu w surowicy, oczekujących na przeszczep wątroby, ryzyko zgonu jest wysokie, mimo niskich wartości skali MELD (Model for End-Stage Liver Disease)46
  • U pacjentów z przewlekłą chorobą nerek hiponatremia wiąże się ze zwiększonym ryzykiem śmiertelności ze wszystkich przyczyn oraz zgonów niezwiązanych z problemami sercowo-naczyniowymi lub złośliwymi47

Wpływ na długość hospitalizacji i wykorzystanie zasobów

Hiponatremia znacząco wpływa na wykorzystanie zasobów opieki zdrowotnej:

  • Pacjenci z hiponatremią mają wydłużony czas pobytu na oddziale intensywnej terapii i w szpitalu (7,6±5,3 vs 7,0±5,2 dni, p<0,001)48
  • Hiponatremia wiąże się ze zwiększonym zapotrzebowaniem na wentylację mechaniczną i opiekę na oddziale intensywnej terapii49
  • Hiponatremia dodaje ponad 1300 dolarów do kosztów opieki u pacjentów z zapaleniem płuc50
  • Osoby z hiponatremią wymagające hospitalizacji mają dłuższy czas pobytu (z powiązanymi zwiększonymi kosztami) oraz większe prawdopodobieństwo ponownego przyjęcia do szpitala, szczególnie dotyczy to mężczyzn i osób w podeszłym wieku51

Hiponatremia w COVID-19

Badania przeprowadzone w Hongkongu wykazały, że hiponatremia występowała u 27,2% pacjentów z COVID-19 przy przyjęciu do szpitala. Pacjenci z hiponatremią mieli zwiększoną 30-dniową śmiertelność (9,7% vs 5,7%, p<0,001), wydłużoną hospitalizację (11,9±15,1 dni vs 11,5±12,1 dni, p<0,001) i więcej przyjęć na oddział intensywnej terapii (7,0% vs 3,3%, p<0,001). Warto zauważyć, że pacjenci zdiagnozowani podczas piątej fali pandemii (wariant Omicron BA.2) mieli 2,29-krotnie większe ryzyko wystąpienia hiponatremii w porównaniu do innych fal.52

Nadzór i monitoring hiponatremii

Pomimo powszechnego występowania, hiponatremia jest często niedostatecznie rozpoznawana i niedostatecznie leczona. W badaniu przeprowadzonym w Chinach ogólna częstość występowania hiponatremii w szpitalu wynosiła 17,5% (26 990 pacjentów), ale tylko 0,26% (394 pacjentów) przypadków zostało zidentyfikowanych za pomocą kodu diagnostycznego hiponatremii.53

Monitorowanie stężenia sodu jest szczególnie ważne u pacjentów z grupy wysokiego ryzyka, takich jak osoby starsze z wieloma chorobami współistniejącymi, pacjenci przyjmujący leki predysponujące do hiponatremii (diuretyki tiazydowe, leki przeciwdepresyjne, leki przeciwpadaczkowe), a także pacjenci z chorobami predysponującymi (niewydolność serca, marskość wątroby, choroby nerek).54

W populacji pediatrycznej zapewnienie odpowiedniej podaży sodu i kontrola stężenia sodu u pacjentów z grupy wysokiego ryzyka (osoby z utratą płynów z przewodu pokarmowego i wysokim ryzykiem zespołu nieadekwatnego wydzielania hormonu antydiuretycznego) są najważniejszymi krokami w zapobieganiu ciężkiej hiponatremii.55

W przypadku hiponatremii wysiłkowej zaleca się bliższe monitorowanie osób z grupy ryzyka oraz wdrożenie skutecznych metod prewencji, identyfikacji i leczenia.56

Podsumowanie badań epidemiologicznych

Badania epidemiologiczne wskazują, że hiponatremia jest najczęstszym zaburzeniem elektrolitowym, którego występowanie zależy od wielu czynników. Jest ona powszechna zarówno wśród pacjentów hospitalizowanych (15-35%), jak i w populacji ogólnej (około 1,7%).5758

Czynniki ryzyka hiponatremii obejmują wiek powyżej 30 lat (ryzyko wzrasta wraz z wiekiem), płeć żeńską, niską masę ciała oraz stosowanie określonych leków (szczególnie diuretyków tiazydowych, SSRI, SNRI i leków przeciwpadaczkowych).5960

Hiponatremia wiąże się z niekorzystnym rokowaniem, zwiększoną śmiertelnością, wydłużoną hospitalizacją oraz zwiększonym wykorzystaniem zasobów opieki zdrowotnej.6162

Biorąc pod uwagę powszechność występowania hiponatremii i jej istotny wpływ na wyniki leczenia, zaleca się zwiększenie czujności diagnostycznej oraz wdrożenie skutecznych strategii monitorowania i leczenia, szczególnie u pacjentów z grupy zwiększonego ryzyka.6364

Populacja Częstość występowania hiponatremii Główne czynniki ryzyka
Populacja ogólna 1,7-1,9% Wiek >30 lat, płeć żeńska, choroby współistniejące
Pacjenci hospitalizowani 15-35% Choroby współistniejące, stosowane leki, wiek podeszły
Pacjenci na oddziałach intensywnej terapii Do 40% Ciężki stan kliniczny, wielochorobowość, politerapia
Pacjenci pooperacyjni 4,4% (w 1. tygodniu po zabiegu) Utrata płynów, leki, stres operacyjny
Pacjenci z niewydolnością serca 27% Leki (diuretyki), aktywacja mechanizmów neurohormonalnych
Pacjenci z marskością wątroby i wodobrzuszem 50% Zaburzenia hemodynamiczne, leki
Pacjenci w podeszłym wieku w domach opieki 30% Wielochorobowość, politerapia, obniżone przyjmowanie płynów
Pacjenci leczeni SSRI 0,5-32% Płeć żeńska, wiek podeszły, niska masa ciała
Pacjenci leczeni diuretykami tiazydowymi 30-39% Płeć żeńska, wiek podeszły, niska masa ciała, cukrzyca
Dzieci hospitalizowane 1% (umiarkowana/ciężka); do 45% (łagodna) Zapalenie płuc, utraty z przewodu pokarmowego
Pacjenci z COVID-19 27,2% Wariant Omicron BA.2, wiek, choroby współistniejące

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  1. 09.04.2026
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Materiały źródłowe

  • #1 Hyponatremia: Practice Essentials, Pathophysiology, Etiology
    https://emedicine.medscape.com/article/767624-overview
    The incidence of hyponatremia depends largely on the patient population and the criteria used to establish the diagnosis. Among hospitalized patients, 15-20% have a serum sodium level of 135 mEq/L, while only 1-4% have a serum sodium level of less than 130 mEq/L. The prevalence of hyponatremia is lower in the ambulatory setting. […] The US armed forces reported 1579 incident diagnoses of exertional hyponatremia among active service members from 2003 through 2018, for a crude overall incidence rate of 7.2 cases per 100,000 person-years. Cases occurred both in training facilities and theaters of war. Diagnosis and treatment without hospitalization was accomplished in 86.3% of cases. […] Severe hyponatremia ( 125 mEq/L) has a high mortality rate. In patients whose serum sodium level falls below 105 mEq/L, and especially in persons with alcohol use disorder, the mortality is over 50%.
  • #2 Hyponatremia – Wikipedia
    https://en.wikipedia.org/wiki/Hyponatremia
    Hyponatremia is the most commonly seen water-electrolyte imbalance. The disorder is more frequent in females, the elderly, and in people who are hospitalized. The number of cases of hyponatremia depends largely on the population. In hospital it affects about 15-20% of people; however, only 3-5% of people who are hospitalized have a sodium level less than 130 mmol/L. Hyponatremia has been reported in up to 30% of the elderly in nursing homes and is also present in approximately 30% of people who are depressed on selective serotonin reuptake inhibitors. […] People who have hyponatremia who require hospitalization have a longer length of stay (with associated increased costs) and also have a higher likelihood of requiring readmission. This is particularly the case in men and in the elderly.
  • #3 Hyponatremia – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK470386/
    Hyponatremia is the most common electrolyte disorder, with a prevalence of 20% to 35% among hospitalized patients. The incidence of hyponatremia is high among critical patients in the intensive care unit (ICU) and also in postoperative patients. This is more common in elderly patients due to multiple comorbidities, multiple medications, and a lack of access to food and drinks. […] Hyponatremia is a common electrolyte abnormality. Sodium levels need to be closely monitored, as this could lead to life-threatening complications if left untreated. This is even more important in patients with renal disease and those who are on diuretics. Good interprofessional communication between the primary care provider and a nephrologist is imperative to keep a close eye on sodium levels and their proper correction as and when needed.
  • #4
    https://pmc.ncbi.nlm.nih.gov/articles/PMC3933395/
    Hyponatremia is the most common electrolyte abnormality in hospitalized patients and is associated with adverse outcomes, but its prevalence and significance in the general U.S. population is unknown. […] We provide the first estimate of the prevalence of hyponatremia in the U.S. population, which in our weighted analysis was 1.72%. […] Hyponatremia was more common in subjects with hypertension, diabetes, coronary artery disease, stroke, chronic obstructive pulmonary disease, cancer, and psychiatric disorders, and less common with those with no comorbidities (1.04%, p0.001). […] Our findings suggest that hyponatremia is a predictor of mortality in the general population independent of age, gender, and comorbid conditions. […] The sodium concentration in our population had a normal distribution with a mean (standard deviation) serum sodium concentration of 139 (1.94)mmol/L.
  • #5 Hyponatremia in Infectious Diseases—A Literature Review
    https://www.mdpi.com/1660-4601/17/15/5320
    Hyponatremia is one of the most common water–electrolyte imbalances in the human organism. Its prevalence reaches 15–30% among hospitalized patients, which is even higher in the intensive care units (ICU), where it reaches up to 40%. The incidence of hyponatremia in the general population is estimated at about 1.74%, according to National Health and Nutrition Examination Survey. […] Furthermore, hyponatremia prevalence was shown to be positively associated with comorbidity, expressed as Charlston Comorbidity Index, and was more profound among the most moribund patients. […] A recently performed meta-analysis has confirmed that the improvement of hyponatremia is independently associated with the reduction of all-cause-mortality risk. […] The primary purpose of this review was to perform a meta-analysis, which would elucidate the impact of hyponatremia on the prognosis, mortality, and outcomes among in-patients with an acute infective process.
  • #6 Hyponatremia in the elderly: challenges and solutions | CIA
    https://www.dovepress.com/hyponatremia-in-the-elderly-challenges-and-solutions-peer-reviewed-fulltext-article-CIA
    Relevant studies also indicate that hyponatremia is related with a poor prognosis in elderly subjects, because it is independently associated with an increased mortality risk. […] The prevalence of hyponatremia in the elderly, similar to the general population, varies considerably depending on the population at risk and the sodium concentration used to define the condition. […] The prevalence of hyponatremia in the community is ~8% and it is increased significantly with age. […] The prevalence of low serum sodium levels is even higher in the health care setting. […] In a prospective study that included patients 65 years, SIAD was the main factor in half of the patients with hyponatremia (serum sodium 135 mmol/L). […] SIAD was also the leading cause of hyponatremia in elderly hospitalized patients with severe hyponatremia (serum sodium 125 mmol/L).
  • #7
    https://pmc.ncbi.nlm.nih.gov/articles/PMC3933395/
    Hyponatremia is the most common electrolyte abnormality in hospitalized patients and is associated with adverse outcomes, but its prevalence and significance in the general U.S. population is unknown. […] We provide the first estimate of the prevalence of hyponatremia in the U.S. population, which in our weighted analysis was 1.72%. […] Hyponatremia was more common in subjects with hypertension, diabetes, coronary artery disease, stroke, chronic obstructive pulmonary disease, cancer, and psychiatric disorders, and less common with those with no comorbidities (1.04%, p0.001). […] Our findings suggest that hyponatremia is a predictor of mortality in the general population independent of age, gender, and comorbid conditions. […] The sodium concentration in our population had a normal distribution with a mean (standard deviation) serum sodium concentration of 139 (1.94)mmol/L.
  • #8 Hyponatremia: Practice Essentials, Pathophysiology, Etiology
    https://emedicine.medscape.com/article/767624-overview
    The incidence of hyponatremia depends largely on the patient population and the criteria used to establish the diagnosis. Among hospitalized patients, 15-20% have a serum sodium level of 135 mEq/L, while only 1-4% have a serum sodium level of less than 130 mEq/L. The prevalence of hyponatremia is lower in the ambulatory setting. […] The US armed forces reported 1579 incident diagnoses of exertional hyponatremia among active service members from 2003 through 2018, for a crude overall incidence rate of 7.2 cases per 100,000 person-years. Cases occurred both in training facilities and theaters of war. Diagnosis and treatment without hospitalization was accomplished in 86.3% of cases. […] Severe hyponatremia ( 125 mEq/L) has a high mortality rate. In patients whose serum sodium level falls below 105 mEq/L, and especially in persons with alcohol use disorder, the mortality is over 50%.
  • #9 Hyponatremia – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK470386/
    Hyponatremia is the most common electrolyte disorder, with a prevalence of 20% to 35% among hospitalized patients. The incidence of hyponatremia is high among critical patients in the intensive care unit (ICU) and also in postoperative patients. This is more common in elderly patients due to multiple comorbidities, multiple medications, and a lack of access to food and drinks. […] Hyponatremia is a common electrolyte abnormality. Sodium levels need to be closely monitored, as this could lead to life-threatening complications if left untreated. This is even more important in patients with renal disease and those who are on diuretics. Good interprofessional communication between the primary care provider and a nephrologist is imperative to keep a close eye on sodium levels and their proper correction as and when needed.
  • #10 Hyponatremia epidemiology and demographics – wikidoc
    https://www.wikidoc.org/index.php/Hyponatremia_epidemiology_and_demographics
    Hyponatremia is the most common electrolyte disorder. Its frequency is higher in females, elderly, and the patients who are hospitalized. The incidence of hyponatremia depends largely on the patient population which is a dependent of the underlying cause. A hospital incidence of 15-30% is common. Age over 30, female gender and lower body weights are risk factors for developing complications associated with hyponatremia. […] Hyponatremia is the most common electrolyte disturbances in clinical practice, occurring in 15%-30% of hospitalized patients (acutely or chronically), 1-2% of this patients present with severe hyponatremia (serum sodium 125 mEq/L). […] Post-operative hyponatremia develops in 4.4% of patients within 1st week of surgery. […] Prevalence of hyponatremia is 1720 per 100,000 in the U.S. population.
  • #11 Hyponatremia in Infectious Diseases—A Literature Review
    https://www.mdpi.com/1660-4601/17/15/5320
    Hyponatremia is one of the most common water–electrolyte imbalances in the human organism. Its prevalence reaches 15–30% among hospitalized patients, which is even higher in the intensive care units (ICU), where it reaches up to 40%. The incidence of hyponatremia in the general population is estimated at about 1.74%, according to National Health and Nutrition Examination Survey. […] Furthermore, hyponatremia prevalence was shown to be positively associated with comorbidity, expressed as Charlston Comorbidity Index, and was more profound among the most moribund patients. […] A recently performed meta-analysis has confirmed that the improvement of hyponatremia is independently associated with the reduction of all-cause-mortality risk. […] The primary purpose of this review was to perform a meta-analysis, which would elucidate the impact of hyponatremia on the prognosis, mortality, and outcomes among in-patients with an acute infective process.
  • #12 Hyponatremia in the intensive care unit: How to avoid a Zugzwang situation? | Annals of Intensive Care | Full Text
    https://annalsofintensivecare.springeropen.com/articles/10.1186/s13613-015-0066-8
    Hyponatremia is the single most frequent electrolyte disturbance encountered in the intensive care unit (ICU) affecting as many as 24.5 % of the patients, depending on its biochemical definition. […] Hyponatremia is known to be closely associated with an altered prognosis among critically ill patients and this holds true even in the face of mildly decreased levels of sodium plasma (PNa) levels. […] Hyponatremia is an independent risk factor for shortened in-hospital survival and a prolonged stay in the ICU. […] Strikingly, it has been repeatedly demonstrated that the mortality risk is correlated to the magnitude of hyponatremia and that even mildly diminished levels of PNa portend a poor prognosis. […] Hyponatremia also exerts a negative impact on patient morbidity and mortality across various specific conditions frequently encountered in the setting of the ICU.
  • #13 Hyponatremia epidemiology and demographics – wikidoc
    https://www.wikidoc.org/index.php/Hyponatremia_epidemiology_and_demographics
    Hyponatremia is the most common electrolyte disorder. Its frequency is higher in females, elderly, and the patients who are hospitalized. The incidence of hyponatremia depends largely on the patient population which is a dependent of the underlying cause. A hospital incidence of 15-30% is common. Age over 30, female gender and lower body weights are risk factors for developing complications associated with hyponatremia. […] Hyponatremia is the most common electrolyte disturbances in clinical practice, occurring in 15%-30% of hospitalized patients (acutely or chronically), 1-2% of this patients present with severe hyponatremia (serum sodium 125 mEq/L). […] Post-operative hyponatremia develops in 4.4% of patients within 1st week of surgery. […] Prevalence of hyponatremia is 1720 per 100,000 in the U.S. population.
  • #14 Hyponatremia epidemiology and demographics – wikidoc
    https://www.wikidoc.org/index.php/Hyponatremia_epidemiology_and_demographics
    Nearly 7.7% of patients who are visited in outpatients clinics are hyponatremic. […] Hyponatremia is seen in up to 27% of patients with heart failure (HF). […] Approximately 50% of patients with cirrhosis and ascites are found to be hyponatremic. […] Hyponatremia has been reported in up to 30% of elderly patients in nursing homes and is also present in approximately 30% of depressed patients on selective serotonin reuptake inhibitors. […] Over the period of 1999-2006, mortality rate was 11% and 4% for hyponatremic and normonatremia subjects, respectively. […] There is an increased risk of mortality in patients with congestive heart failure, renal failure and cirrhosis. […] Hyponatremia is associated with worse clinical outcome, inpatients or outpatients. […] The underlying illness that is associated with hyponatremia has more correlation with mortality rate rather than severity of hyponatremia.
  • #15 Hyponatremia epidemiology and demographics – wikidoc
    https://www.wikidoc.org/index.php/Hyponatremia_epidemiology_and_demographics
    Nearly 7.7% of patients who are visited in outpatients clinics are hyponatremic. […] Hyponatremia is seen in up to 27% of patients with heart failure (HF). […] Approximately 50% of patients with cirrhosis and ascites are found to be hyponatremic. […] Hyponatremia has been reported in up to 30% of elderly patients in nursing homes and is also present in approximately 30% of depressed patients on selective serotonin reuptake inhibitors. […] Over the period of 1999-2006, mortality rate was 11% and 4% for hyponatremic and normonatremia subjects, respectively. […] There is an increased risk of mortality in patients with congestive heart failure, renal failure and cirrhosis. […] Hyponatremia is associated with worse clinical outcome, inpatients or outpatients. […] The underlying illness that is associated with hyponatremia has more correlation with mortality rate rather than severity of hyponatremia.
  • #16 Hyponatremia epidemiology and demographics – wikidoc
    https://www.wikidoc.org/index.php/Hyponatremia_epidemiology_and_demographics
    Nearly 7.7% of patients who are visited in outpatients clinics are hyponatremic. […] Hyponatremia is seen in up to 27% of patients with heart failure (HF). […] Approximately 50% of patients with cirrhosis and ascites are found to be hyponatremic. […] Hyponatremia has been reported in up to 30% of elderly patients in nursing homes and is also present in approximately 30% of depressed patients on selective serotonin reuptake inhibitors. […] Over the period of 1999-2006, mortality rate was 11% and 4% for hyponatremic and normonatremia subjects, respectively. […] There is an increased risk of mortality in patients with congestive heart failure, renal failure and cirrhosis. […] Hyponatremia is associated with worse clinical outcome, inpatients or outpatients. […] The underlying illness that is associated with hyponatremia has more correlation with mortality rate rather than severity of hyponatremia.
  • #17 Hyponatremia in patients with cirrhosis – UpToDate
    https://www.uptodate.com/contents/hyponatremia-in-patients-with-cirrhosis
    Hyponatremia is a common problem in patients with advanced cirrhosis. The pathogenesis, epidemiology, and special management considerations of hyponatremia in patients with cirrhosis are presented in this topic. […] The severity of the hyponatremia is related to the severity of the cirrhosis.
  • #18 Hyponatremia and hospital outcomes among patients with pneumonia: a retrospective cohort study | BMC Pulmonary Medicine | Full Text
    https://bmcpulmmed.biomedcentral.com/articles/10.1186/1471-2466-8-16
    Hyponatremia, occurring in 1/4 of patients with CAP, is associated with greater disease severity and worsened outcomes. […] Hyponatremia was associated with an increased ICU and hospital lengths of stay (LOS, 7.6 5.3 vs. 7.0 5.2 days, p 0.001) and a trend toward increased hospital mortality (5.4% vs. 4.0%, p = 0.1). […] Hyponatremia is common among hospitalized patients with pneumonia and is associated with worsened clinical and economic outcomes. […] Hyponatremia frequently accompanies hospitalization for pneumonia. […] Hyponatremia exerts a negative impact on multiple outcomes such as the need for MV and ICU care, as well as the duration of ICU stay. […] Hyponatremia adds over $1,300 to the costs of care. […] The current study gives rise to the possibility that predictive abilities of the CURB instruments may benefit from the addition of the initial [Na+] value without compromising its simplicity.
  • #19 Hyponatremia epidemiology and demographics – wikidoc
    https://www.wikidoc.org/index.php/Hyponatremia_epidemiology_and_demographics
    Nearly 7.7% of patients who are visited in outpatients clinics are hyponatremic. […] Hyponatremia is seen in up to 27% of patients with heart failure (HF). […] Approximately 50% of patients with cirrhosis and ascites are found to be hyponatremic. […] Hyponatremia has been reported in up to 30% of elderly patients in nursing homes and is also present in approximately 30% of depressed patients on selective serotonin reuptake inhibitors. […] Over the period of 1999-2006, mortality rate was 11% and 4% for hyponatremic and normonatremia subjects, respectively. […] There is an increased risk of mortality in patients with congestive heart failure, renal failure and cirrhosis. […] Hyponatremia is associated with worse clinical outcome, inpatients or outpatients. […] The underlying illness that is associated with hyponatremia has more correlation with mortality rate rather than severity of hyponatremia.
  • #20 Hyponatremia epidemiology and demographics – wikidoc
    https://www.wikidoc.org/index.php/Hyponatremia_epidemiology_and_demographics
    Nearly 7.7% of patients who are visited in outpatients clinics are hyponatremic. […] Hyponatremia is seen in up to 27% of patients with heart failure (HF). […] Approximately 50% of patients with cirrhosis and ascites are found to be hyponatremic. […] Hyponatremia has been reported in up to 30% of elderly patients in nursing homes and is also present in approximately 30% of depressed patients on selective serotonin reuptake inhibitors. […] Over the period of 1999-2006, mortality rate was 11% and 4% for hyponatremic and normonatremia subjects, respectively. […] There is an increased risk of mortality in patients with congestive heart failure, renal failure and cirrhosis. […] Hyponatremia is associated with worse clinical outcome, inpatients or outpatients. […] The underlying illness that is associated with hyponatremia has more correlation with mortality rate rather than severity of hyponatremia.
  • #21 Management of Hyponatremia: Focus on Psychiatric Patients
    https://www.uspharmacist.com/article/management-of-hyponatremia
    Hyponatremia is seen in about 4% of patients with chronic schizophrenia and occasionally in patients with other psychiatric disorders. […] Primary polydipsia is prominent in patients with psychosis, affecting nearly 7% of patients with schizophrenia. […] The incidence of hyponatremia caused by SSRIs varies widely, from 0.5% to 32%. […] Hyponatremia caused by SIADH is due to increased release of antidiuretic hormone (ADH). SIADH has been associated with many drugs often used in psychiatric patients, including nicotine, barbiturates, carbamazepine, antipsychotics, and antidepressants.
  • #22 Management of Hyponatremia: Focus on Psychiatric Patients
    https://www.uspharmacist.com/article/management-of-hyponatremia
    Hyponatremia is seen in about 4% of patients with chronic schizophrenia and occasionally in patients with other psychiatric disorders. […] Primary polydipsia is prominent in patients with psychosis, affecting nearly 7% of patients with schizophrenia. […] The incidence of hyponatremia caused by SSRIs varies widely, from 0.5% to 32%. […] Hyponatremia caused by SIADH is due to increased release of antidiuretic hormone (ADH). SIADH has been associated with many drugs often used in psychiatric patients, including nicotine, barbiturates, carbamazepine, antipsychotics, and antidepressants.
  • #23
    https://experts.mcmaster.ca/display/publication1272526
    Hyponatremia in peritoneal dialysis (PD) patients has previously been associated with water overload and weight gain, or with malnutrition and intracellular potassium depletion. […] We evaluated the incidence and factors associated with hyponatremia in PD patients in a single PD unit. […] The incidence of hyponatremia was 14.5%. […] Hyponatremia is seen more often than expected in a clinical setting.
  • #24 Hyponatremia in Infectious Diseases—A Literature Review
    https://www.mdpi.com/1660-4601/17/15/5320
    Hyponatremia is commonly observed in 27% of patients who suffer from peritoneal-dialysis-related peritonitis (PDRP). […] Hyponatremia is reported to be associated with an unfavorable clinical outcome and predicts the need for mechanical ventilation and critical care intervention in miliary tuberculosis. […] Hyponatremia in infections is a multidisciplinary problem, as it may be associated with the infection itself, but also with a variety of factors such as renal or intracranial pathologies, drugs intake, malnutrition, or critical state. The knowledge about factors predisposing to hyponatremia remains essential for a proper diagnosis and treatment.
  • #25 Hyponatremia | 5-Minute Pediatric Consult
    https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/618343/3.2/Hyponatremia
    Hyponatremia is common in the inpatient setting, and incidence for moderate to severe hyponatremia (130 mEq/L) is ~1% hospitalized pediatric patients and mild hyponatremia (135 mEq/L) is present in up to 45% of pediatric patients admitted for community-acquired pneumonia. […] Providing adequate Na+ intake and checking serum Na+ levels in high-risk patients (GI fluid losses and high risk for SAIDH) is the most important step in prevention of severe hyponatremia.
  • #26 243 – Early onset hyponatremia: Epidemiology and management in extremely preterm infants.
    https://2023.pas-meeting.org/ajaxcalls/PosterInfo.asp?PosterID=563178
    Early onset hyponatremia (EOH) is commonly reported in extremely preterm infants (EPI) admitted to Neonatal Intensive Care Units. […] Epidemiological studies in this population are lacking, and there are no clear guidelines for how to investigate or treat hyponatremia in EPI. […] Prevalence of EOH in EPI was 79%. […] Hyponatremia correlated with fluid overload evident by daily cumulative weight change. […] EOH is very common in EPI, but under-investigated. […] Prospective studies looking at EOH with planned investigations may help better understand the cause of this key electrolyte abnormality in EPI.
  • #27 Hyponatremia: Practice Essentials, Pathophysiology, Etiology
    https://emedicine.medscape.com/article/767624-overview
    The incidence of hyponatremia depends largely on the patient population and the criteria used to establish the diagnosis. Among hospitalized patients, 15-20% have a serum sodium level of 135 mEq/L, while only 1-4% have a serum sodium level of less than 130 mEq/L. The prevalence of hyponatremia is lower in the ambulatory setting. […] The US armed forces reported 1579 incident diagnoses of exertional hyponatremia among active service members from 2003 through 2018, for a crude overall incidence rate of 7.2 cases per 100,000 person-years. Cases occurred both in training facilities and theaters of war. Diagnosis and treatment without hospitalization was accomplished in 86.3% of cases. […] Severe hyponatremia ( 125 mEq/L) has a high mortality rate. In patients whose serum sodium level falls below 105 mEq/L, and especially in persons with alcohol use disorder, the mortality is over 50%.
  • #28 Exertional Hyponatremia Among Active Component Members of the U.S. Armed Forces, 2008–2023 | Health.mil
    https://health.mil/News/Articles/2024/04/01/MSMR-Hyponatremia-2024
    Exertional hyponatremia, or exercise-associated hyponatremia, occurs within 24 hours after physical activity due to a serum, plasma, or blood sodium concentration (Na+) below the normal reference range of 135 mEq/L. If not detected early and managed properly, hyponatremia can be fatal. From 2008 to 2023, 1,812 cases of exertional hyponatremia were diagnosed among U.S. active component service members, with an overall incidence rate of 8.3 cases per 100,000 person-years (p-yrs). […] In 2023 there were 153 cases of exertional hyponatremia diagnosed among ACSMs, resulting in a crude incidence rate of 11.7 per 100,000 p-yrs. […] During the surveillance period, annual rates of incident exertional hyponatremia diagnoses peaked in 2010 (12.8 per 100,000 p-yrs) and then decreased to a low of 5.3 cases per 100,000 p-yrs in 2013. Thereafter the incidence rate fluctuated but has increased from 6.2 per 100,000 p-yrs in 2017 to its second-highest level in 2023.
  • #29 Exertional Hyponatremia Among Active Component Members of the U.S. Armed Forces, 2008–2023 | Health.mil
    https://health.mil/News/Articles/2024/04/01/MSMR-Hyponatremia-2024
    Exertional hyponatremia, or exercise-associated hyponatremia, occurs within 24 hours after physical activity due to a serum, plasma, or blood sodium concentration (Na+) below the normal reference range of 135 mEq/L. If not detected early and managed properly, hyponatremia can be fatal. From 2008 to 2023, 1,812 cases of exertional hyponatremia were diagnosed among U.S. active component service members, with an overall incidence rate of 8.3 cases per 100,000 person-years (p-yrs). […] In 2023 there were 153 cases of exertional hyponatremia diagnosed among ACSMs, resulting in a crude incidence rate of 11.7 per 100,000 p-yrs. […] During the surveillance period, annual rates of incident exertional hyponatremia diagnoses peaked in 2010 (12.8 per 100,000 p-yrs) and then decreased to a low of 5.3 cases per 100,000 p-yrs in 2013. Thereafter the incidence rate fluctuated but has increased from 6.2 per 100,000 p-yrs in 2017 to its second-highest level in 2023.
  • #30 Hyponatremia epidemiology and demographics – wikidoc
    https://www.wikidoc.org/index.php/Hyponatremia_epidemiology_and_demographics
    Age over 30 is related to increased overall incident of hyponatremia especially hospital acquired hyponatremia. The association is stronger even with increasing severity of hyponatremia. […] In elderly patients, lower body weight is associated with increased risk of drug-induced hyponatremia. […] Female sex is considered a risk factor for psychotropic and diuretic-induced hyponatremia. […] Severe hyponatremia occurs more frequently in women because of lower body weight.
  • #31 Hyponatremia: Practice Essentials, Pathophysiology, Etiology
    https://emedicine.medscape.com/article/767624-overview
    Hyponatremia affects all races. […] No sexual predilection exists for hyponatremia. However, symptoms are more likely to occur in young women than in men. Hyponatremia is more common in elderly persons partially because of higher rate of comorbid conditions (eg, heart, liver, or kidney failure) that can lead to hyponatremia.
  • #32 Hyponatremia – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK470386/
    Hyponatremia is the most common electrolyte disorder, with a prevalence of 20% to 35% among hospitalized patients. The incidence of hyponatremia is high among critical patients in the intensive care unit (ICU) and also in postoperative patients. This is more common in elderly patients due to multiple comorbidities, multiple medications, and a lack of access to food and drinks. […] Hyponatremia is a common electrolyte abnormality. Sodium levels need to be closely monitored, as this could lead to life-threatening complications if left untreated. This is even more important in patients with renal disease and those who are on diuretics. Good interprofessional communication between the primary care provider and a nephrologist is imperative to keep a close eye on sodium levels and their proper correction as and when needed.
  • #33
    https://pmc.ncbi.nlm.nih.gov/articles/PMC3933395/
    The weighted prevalence of hyponatremia in our NHANES cohort was 1.72% (1.89% including cases of dilutional hyponatremia) and was significantly more common among females than males (2.1% vs. 1.3%, p=0.0044). […] Subjects with one or more comorbidities had a significantly higher prevalence of hyponatremia than the overall cohort at 2.26% (p=0.0001). […] Mortality data was available for 14,679 subjects (99.9%) of our cohort. […] The overall mortality rate over the period 1999-2006 for hyponatremic subjects was 11% versus 4% for subjects with normonatremia (unadjusted relative hazard ratio 3.61). […] Cox regression models that included adjustment for age and gender attenuated the association of hyponatremia and all-cause mortality slightly (HR 2.24, p=0.001), but risk of mortality remained significantly elevated for subjects with hyponatremia after further adjustment for comorbidities, ethnicity, insurance status, and smoking (HR, 2.43; P .001).
  • #34 Hyponatremia epidemiology and demographics – wikidoc
    https://www.wikidoc.org/index.php/Hyponatremia_epidemiology_and_demographics
    Age over 30 is related to increased overall incident of hyponatremia especially hospital acquired hyponatremia. The association is stronger even with increasing severity of hyponatremia. […] In elderly patients, lower body weight is associated with increased risk of drug-induced hyponatremia. […] Female sex is considered a risk factor for psychotropic and diuretic-induced hyponatremia. […] Severe hyponatremia occurs more frequently in women because of lower body weight.
  • #35 Hyponatremia epidemiology and demographics – wikidoc
    https://www.wikidoc.org/index.php/Hyponatremia_epidemiology_and_demographics
    Age over 30 is related to increased overall incident of hyponatremia especially hospital acquired hyponatremia. The association is stronger even with increasing severity of hyponatremia. […] In elderly patients, lower body weight is associated with increased risk of drug-induced hyponatremia. […] Female sex is considered a risk factor for psychotropic and diuretic-induced hyponatremia. […] Severe hyponatremia occurs more frequently in women because of lower body weight.
  • #36 Hyponatremia: Practice Essentials, Pathophysiology, Etiology
    https://emedicine.medscape.com/article/767624-overview
    Hyponatremia affects all races. […] No sexual predilection exists for hyponatremia. However, symptoms are more likely to occur in young women than in men. Hyponatremia is more common in elderly persons partially because of higher rate of comorbid conditions (eg, heart, liver, or kidney failure) that can lead to hyponatremia.
  • #37 Hyponatremia epidemiology and demographics – wikidoc
    https://www.wikidoc.org/index.php/Hyponatremia_epidemiology_and_demographics
    Age over 30 is related to increased overall incident of hyponatremia especially hospital acquired hyponatremia. The association is stronger even with increasing severity of hyponatremia. […] In elderly patients, lower body weight is associated with increased risk of drug-induced hyponatremia. […] Female sex is considered a risk factor for psychotropic and diuretic-induced hyponatremia. […] Severe hyponatremia occurs more frequently in women because of lower body weight.
  • #38
    https://www.archivesofmedicalscience.com/Hyponatremia-in-patients-with-arterial-hypertension-pathophysiology-and-management,161578,0,2.html
    In a retrospective study assessing the risk of hyponatremia in patients with arterial hypertension, including 220 patients using thiazide diuretics and 2393 subjects not using them, hyponatremia was found in 30% of patients using these diuretics. […] The incidence of hyponatremia increases with age in patients using thiazide or thiazide-like diuretics.
  • #39
    https://journals.lww.com/sjkd/fulltext/2013/24020/prevalence_of_hyponatremia_among_patients_who_used.9.aspx
    Hyponatremia is the most frequently encountered electrolyte abnormality among hospitalized patients and thiazide users. […] The overall prevalence of hyponatremia, regardless of severity, in the indapamide group was 37.3% versus 38.7% in the hydrochlorothiazide group. […] The overall prevalence of hyponatremia among Saudi thiazide users is relatively high, and more so for the elderly and for those with T2DM. […] The prevalence of hyponatremia in the US is much lower as compared with European hospitals, where the highest incidence was noted in geriatric wards (22.2%) and nursing homes (18.8%). […] To date, there is scarcity of information with regard to the epidemiology of hyponatremia in the Kingdom of Saudi Arabia. […] The main finding of the present cross-sectional and retrospective study is the moderately high prevalence of hyponatremia among the study patients, regardless of the thiazide drug used, and that this is more pronounced among patients with pre-existing T2DM. […] In summary, the prevalence of hyponatremia among Saudi thiazide users is relatively high.
  • #40
    https://link.springer.com/article/10.1007/s00702-021-02369-1
    Hyponatremia (HN) is the most common electrolyte imbalance (defined as a serum sodium concentration Na(S) of 130 mmol/l) and often induced by drugs including psychotropic drugs. […] A total of 210 cases of HN were observed affecting 0.05% of patients. […] The incidence of HN was highest among the two antiepileptic drugs oxcarbazepine (1.661% of patients treated) and carbamazepine (0.169%), followed by selective serotonin-norepinephrine reuptake inhibitors (SSNRIs, 0.088%) and selective serotonin reuptake inhibitors (0.071%). […] The identification of high-risk drug combinations and vulnerable patient subgroups represents a significant step in the improvement of drug safety and facilitates the implementation of precautionary measures. […] A total of 495,615 psychiatric inpatients were monitored within the hospitals participating in the AMSP project between 1993 and 2016. 93.4% of patients (462,661 patients) were treated with at least one psychotropic drug.
  • #41
    https://pmc.ncbi.nlm.nih.gov/articles/PMC3933395/
    Hyponatremia is the most common electrolyte abnormality in hospitalized patients and is associated with adverse outcomes, but its prevalence and significance in the general U.S. population is unknown. […] We provide the first estimate of the prevalence of hyponatremia in the U.S. population, which in our weighted analysis was 1.72%. […] Hyponatremia was more common in subjects with hypertension, diabetes, coronary artery disease, stroke, chronic obstructive pulmonary disease, cancer, and psychiatric disorders, and less common with those with no comorbidities (1.04%, p0.001). […] Our findings suggest that hyponatremia is a predictor of mortality in the general population independent of age, gender, and comorbid conditions. […] The sodium concentration in our population had a normal distribution with a mean (standard deviation) serum sodium concentration of 139 (1.94)mmol/L.
  • #42 Hyponatremia in the intensive care unit: How to avoid a Zugzwang situation? | Annals of Intensive Care | Full Text
    https://annalsofintensivecare.springeropen.com/articles/10.1186/s13613-015-0066-8
    Hyponatremia is the single most frequent electrolyte disturbance encountered in the intensive care unit (ICU) affecting as many as 24.5 % of the patients, depending on its biochemical definition. […] Hyponatremia is known to be closely associated with an altered prognosis among critically ill patients and this holds true even in the face of mildly decreased levels of sodium plasma (PNa) levels. […] Hyponatremia is an independent risk factor for shortened in-hospital survival and a prolonged stay in the ICU. […] Strikingly, it has been repeatedly demonstrated that the mortality risk is correlated to the magnitude of hyponatremia and that even mildly diminished levels of PNa portend a poor prognosis. […] Hyponatremia also exerts a negative impact on patient morbidity and mortality across various specific conditions frequently encountered in the setting of the ICU.
  • #43
    https://pmc.ncbi.nlm.nih.gov/articles/PMC3933395/
    The weighted prevalence of hyponatremia in our NHANES cohort was 1.72% (1.89% including cases of dilutional hyponatremia) and was significantly more common among females than males (2.1% vs. 1.3%, p=0.0044). […] Subjects with one or more comorbidities had a significantly higher prevalence of hyponatremia than the overall cohort at 2.26% (p=0.0001). […] Mortality data was available for 14,679 subjects (99.9%) of our cohort. […] The overall mortality rate over the period 1999-2006 for hyponatremic subjects was 11% versus 4% for subjects with normonatremia (unadjusted relative hazard ratio 3.61). […] Cox regression models that included adjustment for age and gender attenuated the association of hyponatremia and all-cause mortality slightly (HR 2.24, p=0.001), but risk of mortality remained significantly elevated for subjects with hyponatremia after further adjustment for comorbidities, ethnicity, insurance status, and smoking (HR, 2.43; P .001).
  • #44 Hyponatremia: Practice Essentials, Pathophysiology, Etiology
    https://emedicine.medscape.com/article/767624-overview
    The incidence of hyponatremia depends largely on the patient population and the criteria used to establish the diagnosis. Among hospitalized patients, 15-20% have a serum sodium level of 135 mEq/L, while only 1-4% have a serum sodium level of less than 130 mEq/L. The prevalence of hyponatremia is lower in the ambulatory setting. […] The US armed forces reported 1579 incident diagnoses of exertional hyponatremia among active service members from 2003 through 2018, for a crude overall incidence rate of 7.2 cases per 100,000 person-years. Cases occurred both in training facilities and theaters of war. Diagnosis and treatment without hospitalization was accomplished in 86.3% of cases. […] Severe hyponatremia ( 125 mEq/L) has a high mortality rate. In patients whose serum sodium level falls below 105 mEq/L, and especially in persons with alcohol use disorder, the mortality is over 50%.
  • #45 Hyponatremia: Practice Essentials, Pathophysiology, Etiology
    https://emedicine.medscape.com/article/767624-overview
    In patients with acute ST-elevation myocardial infarction (MI), the presence of hyponatremia on admission or early development of hyponatremia is an independent predictor of 30-day mortality, and the prognosis worsens with the severity of hyponatremia. […] Similarly, cirrhotic patients with persistent ascites and a low serum sodium level who are awaiting liver transplantation have a high mortality risk despite low-severity Model for End-Stage Liver Disease (MELD) scores. […] In patients with chronic kidney disease, hyponatremia and hypernatremia are associated with an increased risk for all-cause mortality and for deaths unrelated to cardiovascular problems or malignancy. Hyponatremia is also linked to an increased risk for cardiovascular- and malignancy-related mortality in these patients.
  • #46 Hyponatremia: Practice Essentials, Pathophysiology, Etiology
    https://emedicine.medscape.com/article/767624-overview
    In patients with acute ST-elevation myocardial infarction (MI), the presence of hyponatremia on admission or early development of hyponatremia is an independent predictor of 30-day mortality, and the prognosis worsens with the severity of hyponatremia. […] Similarly, cirrhotic patients with persistent ascites and a low serum sodium level who are awaiting liver transplantation have a high mortality risk despite low-severity Model for End-Stage Liver Disease (MELD) scores. […] In patients with chronic kidney disease, hyponatremia and hypernatremia are associated with an increased risk for all-cause mortality and for deaths unrelated to cardiovascular problems or malignancy. Hyponatremia is also linked to an increased risk for cardiovascular- and malignancy-related mortality in these patients.
  • #47 Hyponatremia: Practice Essentials, Pathophysiology, Etiology
    https://emedicine.medscape.com/article/767624-overview
    In patients with acute ST-elevation myocardial infarction (MI), the presence of hyponatremia on admission or early development of hyponatremia is an independent predictor of 30-day mortality, and the prognosis worsens with the severity of hyponatremia. […] Similarly, cirrhotic patients with persistent ascites and a low serum sodium level who are awaiting liver transplantation have a high mortality risk despite low-severity Model for End-Stage Liver Disease (MELD) scores. […] In patients with chronic kidney disease, hyponatremia and hypernatremia are associated with an increased risk for all-cause mortality and for deaths unrelated to cardiovascular problems or malignancy. Hyponatremia is also linked to an increased risk for cardiovascular- and malignancy-related mortality in these patients.
  • #48 Hyponatremia and hospital outcomes among patients with pneumonia: a retrospective cohort study | BMC Pulmonary Medicine | Full Text
    https://bmcpulmmed.biomedcentral.com/articles/10.1186/1471-2466-8-16
    Hyponatremia, occurring in 1/4 of patients with CAP, is associated with greater disease severity and worsened outcomes. […] Hyponatremia was associated with an increased ICU and hospital lengths of stay (LOS, 7.6 5.3 vs. 7.0 5.2 days, p 0.001) and a trend toward increased hospital mortality (5.4% vs. 4.0%, p = 0.1). […] Hyponatremia is common among hospitalized patients with pneumonia and is associated with worsened clinical and economic outcomes. […] Hyponatremia frequently accompanies hospitalization for pneumonia. […] Hyponatremia exerts a negative impact on multiple outcomes such as the need for MV and ICU care, as well as the duration of ICU stay. […] Hyponatremia adds over $1,300 to the costs of care. […] The current study gives rise to the possibility that predictive abilities of the CURB instruments may benefit from the addition of the initial [Na+] value without compromising its simplicity.
  • #49 Hyponatremia and hospital outcomes among patients with pneumonia: a retrospective cohort study | BMC Pulmonary Medicine | Full Text
    https://bmcpulmmed.biomedcentral.com/articles/10.1186/1471-2466-8-16
    Hyponatremia, occurring in 1/4 of patients with CAP, is associated with greater disease severity and worsened outcomes. […] Hyponatremia was associated with an increased ICU and hospital lengths of stay (LOS, 7.6 5.3 vs. 7.0 5.2 days, p 0.001) and a trend toward increased hospital mortality (5.4% vs. 4.0%, p = 0.1). […] Hyponatremia is common among hospitalized patients with pneumonia and is associated with worsened clinical and economic outcomes. […] Hyponatremia frequently accompanies hospitalization for pneumonia. […] Hyponatremia exerts a negative impact on multiple outcomes such as the need for MV and ICU care, as well as the duration of ICU stay. […] Hyponatremia adds over $1,300 to the costs of care. […] The current study gives rise to the possibility that predictive abilities of the CURB instruments may benefit from the addition of the initial [Na+] value without compromising its simplicity.
  • #50 Hyponatremia and hospital outcomes among patients with pneumonia: a retrospective cohort study | BMC Pulmonary Medicine | Full Text
    https://bmcpulmmed.biomedcentral.com/articles/10.1186/1471-2466-8-16
    Hyponatremia, occurring in 1/4 of patients with CAP, is associated with greater disease severity and worsened outcomes. […] Hyponatremia was associated with an increased ICU and hospital lengths of stay (LOS, 7.6 5.3 vs. 7.0 5.2 days, p 0.001) and a trend toward increased hospital mortality (5.4% vs. 4.0%, p = 0.1). […] Hyponatremia is common among hospitalized patients with pneumonia and is associated with worsened clinical and economic outcomes. […] Hyponatremia frequently accompanies hospitalization for pneumonia. […] Hyponatremia exerts a negative impact on multiple outcomes such as the need for MV and ICU care, as well as the duration of ICU stay. […] Hyponatremia adds over $1,300 to the costs of care. […] The current study gives rise to the possibility that predictive abilities of the CURB instruments may benefit from the addition of the initial [Na+] value without compromising its simplicity.
  • #51 Hyponatremia – Wikipedia
    https://en.wikipedia.org/wiki/Hyponatremia
    Hyponatremia is the most commonly seen water-electrolyte imbalance. The disorder is more frequent in females, the elderly, and in people who are hospitalized. The number of cases of hyponatremia depends largely on the population. In hospital it affects about 15-20% of people; however, only 3-5% of people who are hospitalized have a sodium level less than 130 mmol/L. Hyponatremia has been reported in up to 30% of the elderly in nursing homes and is also present in approximately 30% of people who are depressed on selective serotonin reuptake inhibitors. […] People who have hyponatremia who require hospitalization have a longer length of stay (with associated increased costs) and also have a higher likelihood of requiring readmission. This is particularly the case in men and in the elderly.
  • #52 HKU Scholars Hub: Epidemiology and outcomes of hyponatremia in patients with COVID-19—A territory-wide study in Hong Kong
    https://hub.hku.hk/handle/10722/325595
    Background: Hyponatremia is common in COVID-19, but its epidemiology and impact on clinical outcomes in relation to different variants, especially the Omicron variant, requires further clarification. […] This was a territory-wide retrospective study to investigate the epidemiology and outcomes of COVID-19 patients with hyponatremia from January 1, 2020 to March 31, 2022 in Hong Kong. […] A total of 53,415 COVID-19 patients were included for analysis, of which 14,545 (27.2%) had hyponatremia at presentation. […] Hyponatremic patients had increased 30-day mortality (9.7 vs. 5.7%, P 0.001), prolonged hospitalization (11.9 15.1 days vs. 11.5 12.1 days, P 0.001), and more ICU admissions (7.0% vs. 3.3%, P 0.001). […] Patients diagnosed during the fifth wave Omicron BA.2 outbreak had 2.29-fold risk (95% CI 2.022.59, P 0.001) of presenting with hyponatremia compared to other waves. […] Hyponatremia is common among COVID-19 patients, and may serve as a prognostic indicator for unfavorable outcomes and increased healthcare utilization in the evolving COVID-19 outbreak.
  • #53 The prevalence and mortality of hyponatremia is seriously underestimated in Chinese general medical patients: an observational retrospective study | BMC Nephrology | Full Text
    https://bmcnephrol.biomedcentral.com/articles/10.1186/s12882-017-0744-x
    Hyponatremia (serum sodium concentration 135 mmol/L) is the most common electrolyte abnormality and is a predictor of the mortality of hospitalized patients in Western countries. However, hyponatremia data are lacking in Asian countries. Here we evaluate the epidemiology and mortality of hyponatremia in general medical hospitalized patients in China. […] The overall prevalence of hyponatremia at some point during hospitalization was 17.5% (26,990 patients), but only 0.26% (394 patients) of cases were identified with the diagnostic code of hyponatremia. […] Hyponatremia is highly prevalent among Chinese hospitalized patients and is associated with increased in-hospital mortality risk. […] To date, few data exist on the prevalence and prognostic effect of hyponatremia on admitted general medical patients in Asia.
  • #54 Hyponatremia – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK470386/
    Hyponatremia is the most common electrolyte disorder, with a prevalence of 20% to 35% among hospitalized patients. The incidence of hyponatremia is high among critical patients in the intensive care unit (ICU) and also in postoperative patients. This is more common in elderly patients due to multiple comorbidities, multiple medications, and a lack of access to food and drinks. […] Hyponatremia is a common electrolyte abnormality. Sodium levels need to be closely monitored, as this could lead to life-threatening complications if left untreated. This is even more important in patients with renal disease and those who are on diuretics. Good interprofessional communication between the primary care provider and a nephrologist is imperative to keep a close eye on sodium levels and their proper correction as and when needed.
  • #55 Hyponatremia | 5-Minute Pediatric Consult
    https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/618343/3.2/Hyponatremia
    Hyponatremia is common in the inpatient setting, and incidence for moderate to severe hyponatremia (130 mEq/L) is ~1% hospitalized pediatric patients and mild hyponatremia (135 mEq/L) is present in up to 45% of pediatric patients admitted for community-acquired pneumonia. […] Providing adequate Na+ intake and checking serum Na+ levels in high-risk patients (GI fluid losses and high risk for SAIDH) is the most important step in prevention of severe hyponatremia.
  • #56 Exertional Hyponatremia Among Active Component Members of the U.S. Armed Forces, 2008–2023 | Health.mil
    https://health.mil/News/Articles/2024/04/01/MSMR-Hyponatremia-2024
    The incidence of exertional hyponatremia fluctuated more in women than in men. […] Considering the increased incidence rate of exertional hyponatremia in 2023, continued emphasis should be placed on how to effectively manage exertional hyponatremia, including prevention, identification, and treatment methods through close monitoring.
  • #57 Hyponatremia – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK470386/
    Hyponatremia is the most common electrolyte disorder, with a prevalence of 20% to 35% among hospitalized patients. The incidence of hyponatremia is high among critical patients in the intensive care unit (ICU) and also in postoperative patients. This is more common in elderly patients due to multiple comorbidities, multiple medications, and a lack of access to food and drinks. […] Hyponatremia is a common electrolyte abnormality. Sodium levels need to be closely monitored, as this could lead to life-threatening complications if left untreated. This is even more important in patients with renal disease and those who are on diuretics. Good interprofessional communication between the primary care provider and a nephrologist is imperative to keep a close eye on sodium levels and their proper correction as and when needed.
  • #58
    https://pmc.ncbi.nlm.nih.gov/articles/PMC3933395/
    Hyponatremia is the most common electrolyte abnormality in hospitalized patients and is associated with adverse outcomes, but its prevalence and significance in the general U.S. population is unknown. […] We provide the first estimate of the prevalence of hyponatremia in the U.S. population, which in our weighted analysis was 1.72%. […] Hyponatremia was more common in subjects with hypertension, diabetes, coronary artery disease, stroke, chronic obstructive pulmonary disease, cancer, and psychiatric disorders, and less common with those with no comorbidities (1.04%, p0.001). […] Our findings suggest that hyponatremia is a predictor of mortality in the general population independent of age, gender, and comorbid conditions. […] The sodium concentration in our population had a normal distribution with a mean (standard deviation) serum sodium concentration of 139 (1.94)mmol/L.
  • #59 Hyponatremia epidemiology and demographics – wikidoc
    https://www.wikidoc.org/index.php/Hyponatremia_epidemiology_and_demographics
    Age over 30 is related to increased overall incident of hyponatremia especially hospital acquired hyponatremia. The association is stronger even with increasing severity of hyponatremia. […] In elderly patients, lower body weight is associated with increased risk of drug-induced hyponatremia. […] Female sex is considered a risk factor for psychotropic and diuretic-induced hyponatremia. […] Severe hyponatremia occurs more frequently in women because of lower body weight.
  • #60
    https://link.springer.com/article/10.1007/s00702-021-02369-1
    The risk of HN under treatment with SSRIs, SSNRIs, and carbamazepine increased significantly when combined with other potentially HN-inducing drugs used in the treatment of internal illnesses such as DIUs, ACE-Is, ARBs, and PPIs. […] This study found that women aged 65 years and older treated with SSNRIs with concomitant drug use had a particularly high risk of developing drug-induced HN.
  • #61
    https://pmc.ncbi.nlm.nih.gov/articles/PMC3933395/
    Hyponatremia is the most common electrolyte abnormality in hospitalized patients and is associated with adverse outcomes, but its prevalence and significance in the general U.S. population is unknown. […] We provide the first estimate of the prevalence of hyponatremia in the U.S. population, which in our weighted analysis was 1.72%. […] Hyponatremia was more common in subjects with hypertension, diabetes, coronary artery disease, stroke, chronic obstructive pulmonary disease, cancer, and psychiatric disorders, and less common with those with no comorbidities (1.04%, p0.001). […] Our findings suggest that hyponatremia is a predictor of mortality in the general population independent of age, gender, and comorbid conditions. […] The sodium concentration in our population had a normal distribution with a mean (standard deviation) serum sodium concentration of 139 (1.94)mmol/L.
  • #62 Hyponatremia and hospital outcomes among patients with pneumonia: a retrospective cohort study | BMC Pulmonary Medicine | Full Text
    https://bmcpulmmed.biomedcentral.com/articles/10.1186/1471-2466-8-16
    Hyponatremia, occurring in 1/4 of patients with CAP, is associated with greater disease severity and worsened outcomes. […] Hyponatremia was associated with an increased ICU and hospital lengths of stay (LOS, 7.6 5.3 vs. 7.0 5.2 days, p 0.001) and a trend toward increased hospital mortality (5.4% vs. 4.0%, p = 0.1). […] Hyponatremia is common among hospitalized patients with pneumonia and is associated with worsened clinical and economic outcomes. […] Hyponatremia frequently accompanies hospitalization for pneumonia. […] Hyponatremia exerts a negative impact on multiple outcomes such as the need for MV and ICU care, as well as the duration of ICU stay. […] Hyponatremia adds over $1,300 to the costs of care. […] The current study gives rise to the possibility that predictive abilities of the CURB instruments may benefit from the addition of the initial [Na+] value without compromising its simplicity.
  • #63 Hyponatremia – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK470386/
    Hyponatremia is the most common electrolyte disorder, with a prevalence of 20% to 35% among hospitalized patients. The incidence of hyponatremia is high among critical patients in the intensive care unit (ICU) and also in postoperative patients. This is more common in elderly patients due to multiple comorbidities, multiple medications, and a lack of access to food and drinks. […] Hyponatremia is a common electrolyte abnormality. Sodium levels need to be closely monitored, as this could lead to life-threatening complications if left untreated. This is even more important in patients with renal disease and those who are on diuretics. Good interprofessional communication between the primary care provider and a nephrologist is imperative to keep a close eye on sodium levels and their proper correction as and when needed.
  • #64 Hyponatremia in Infectious Diseases—A Literature Review
    https://www.mdpi.com/1660-4601/17/15/5320
    Hyponatremia is one of the most common water–electrolyte imbalances in the human organism. Its prevalence reaches 15–30% among hospitalized patients, which is even higher in the intensive care units (ICU), where it reaches up to 40%. The incidence of hyponatremia in the general population is estimated at about 1.74%, according to National Health and Nutrition Examination Survey. […] Furthermore, hyponatremia prevalence was shown to be positively associated with comorbidity, expressed as Charlston Comorbidity Index, and was more profound among the most moribund patients. […] A recently performed meta-analysis has confirmed that the improvement of hyponatremia is independently associated with the reduction of all-cause-mortality risk. […] The primary purpose of this review was to perform a meta-analysis, which would elucidate the impact of hyponatremia on the prognosis, mortality, and outcomes among in-patients with an acute infective process.

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