Hyponatremia for Everyone. #8. Prognosis of Hyponatremia

By Second Medical Opinions PLC | SMO Blog Kidney | 27 Nov 2019

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This post appeared here, as part of a series. The author is the same. The series was published as an ebook, which you can find in Amazon Kindle format and Apple Books Format.

Picture purchased and downloaded from istockphoto.com under a standard license Author: Nerthuz

In the majority of cases, the prognosis of hyponatremia is benign. As soon as the sodium level is restored and the problem which caused it corrected, the hyponatremia usually does not recur and rarely there are sequelae related to it. This is the case when the low sodium is related to volume depletion or to hypertonic conditions such as hyperglycemia. However, in cases such as the syndrome of inappropriate secretion of anti diuretic hormone (SIADH), the sodium level will be persistently low and difficult to treat. Chronic therapies with medications such as demeclocycline or tolvaptan may be needed and the patient is at persistent risk of encephalopathy, falls, seizures and possibly death. In the case of cirrhosis or heart failure, hyponatremia is a marker of poor prognosis of the underlying condition and expresses how severe this underlying condition is1.

If the correction of hyponatremia is too fast, osmotic demyelination syndrome (ODS) can occur. If this happens, the healthcare prognosis of the patient may be extremely poor due to the severe neurologic sequelae which may include quadriplegia and locked-in syndrome2.