Hyponatriëmie: Stel de juiste vragen

Translated title of the contribution: Hyponatraemia: Ask the right questions

Ewout J. Hoorn*, Karin A.H. Kaasjager, Robert Zietse

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Asking the right questions in these two cases helped to identify their dangers and to plan the right treatment. In both patients hyponatraemia was truly hypotonic (low serum osmolality). In the first patient, hyponatraemia was acute and symptomatic, warranting hypertonic saline for cerebral edema. In the second patient hyponatraemia was likely chronic, but she was mildly symptomatic. Therefore, a moderate rise in serum sodium was established with hypertonic saline, followed by a gradual correction to prevent osmotic demyelination. In both patients vasopressin was elevated (high urine osmolality) due to their medication (risperidone and the thiazide diuretic, respectively). Finally, both patients did not have signs of a low effective arterial blood volume and therefore had no indication for treatment with isotonic saline.

Translated title of the contributionHyponatraemia: Ask the right questions
Original languageDutch
Article numberA7139
JournalNederlands Tijdschrift voor Geneeskunde
Volume158
Issue number9
Publication statusPublished - 2014

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