Hyponatremia in spinal cord injury patients: new insight into differentiating between the dilution and depletion forms
Language English Country England, Great Britain Media print-electronic
Document type Journal Article
PubMed
25582714
DOI
10.1038/sc.2014.240
PII: sc2014240
Knihovny.cz E-resources
- MeSH
- Models, Biological MeSH
- Sodium Chloride analysis MeSH
- Diagnosis, Differential MeSH
- Adult MeSH
- Electrolytes chemistry MeSH
- Hospitalization MeSH
- Hyponatremia blood diagnosis etiology MeSH
- Middle Aged MeSH
- Humans MeSH
- Spinal Cord Injuries blood complications therapy MeSH
- Retrospective Studies MeSH
- Aged MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Geographicals
- Czech Republic MeSH
- Names of Substances
- Sodium Chloride MeSH
- Electrolytes MeSH
STUDY DESIGN: This is a retrospective study. OBJECTIVES: The objectives of this study were to present a new model for differentiating between the dilution and depletion forms of hyponatremia in patients in the postacute phase after spinal cord injury (SCI), and to identify possible etiological factors contributing to hyponatremia in these patients. SETTING: University Hospital Motol, Prague, Czech Republic. METHODS: Eighty-seven of 352 patients hospitalized in 2008-2012 in the Spinal Cord Unit were hyponatremic. Seventy-four patients had SNa+=130-135 mmol l(-1) and 13 patients had SNa+ below 130 mmol l(-1). We propose a simple model of an electrolyte solution in which the Na(+) concentration is higher than the Cl(-) concentration, making it possible to compare the effects of dilution and depletion of Na(+) and Cl(-) on the Na(+) concentration. The depletion of Na(+) and Cl(-) leads to a significant increase in the Na(+)/Cl(-) ratio, with the Na(+)-Cl(-) value remaining unchanged. Dilution with water results in a decrease of Na(+)-Cl(-) with the Na(+)/Cl(-) ratio remaining unchanged. RESULTS: In patients with SNa+ below 130 mmol l(-1), hyponatremia was consistent with the depletion model in 46% and with the dilution model in 32%. In patients with SNa+ ranging between 130 and 135 mmol l(-1), the respective rates were 34 and 12%. CONCLUSION: Examination of SNa+-SCl- and SNa+/SCl- in patients with SCI could be helpful in considering whether hyponatremia is consistent either with the NaCl dilution model or with the NaCl depletion model. Further studies are needed for more accurate interpretation of the results, particularly with respect to volume and acid-base disorders.
Internal Clinic University Hospital Motol Prague Czech Republic
Spinal Cord Unit University Hospital Motol Prague Czech Republic
See more in PubMed
Eur J Pediatr. 2012 Jun;171(6):963-9 PubMed
J Crit Care. 2010 Sep;25(3):525-31 PubMed
Clin Ther. 2007 Feb;29(2):211-29 PubMed
Curr Opin Crit Care. 2008 Dec;14(6):627-34 PubMed
Spine (Phila Pa 1976). 2009 Mar 1;34(5):501-11 PubMed
J Rehabil Res Dev. 2007;44(1):103-12 PubMed
J Appl Physiol (1985). 1998 Mar;84(3):914-21 PubMed
Am J Med. 2013 Oct;126(10 Suppl 1):S1-42 PubMed
Am J Respir Crit Care Med. 2000 Dec;162(6):2246-51 PubMed
Ren Fail. 2009;31(8):625-32 PubMed
Nephron Physiol. 2008;108(3):p46-59 PubMed
Perm J. 2010 Summer;14(2):62-5 PubMed
Psychiatry Res. 2014 Jul 30;217(3):129-33 PubMed
Spinal Cord. 2012 Apr;50(4):285-8 PubMed
Am J Kidney Dis. 2008 Jul;52(1):144-53 PubMed
Crit Care Med. 1994 Feb;22(2):252-8 PubMed
Nephrol Dial Transplant. 2014 Apr;29 Suppl 2:i1-i39 PubMed
Int J Artif Organs. 2005 Oct;28(10):961-5 PubMed
Spinal Cord. 2007 Aug;45(8):563-8 PubMed
Br J Anaesth. 2004 Jan;92(1):54-60 PubMed
Paraplegia. 1994 Sep;32(9):597-607 PubMed
Clin Kidney J. 2013 Nov;6(Suppl 1):i1-i20 PubMed