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Normoosmolar HyponatremiaAka: Iso-Osmolar Hyponatremia, Pseudohyponatremia

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  1. See Also
    1. Hyponatremia
  2. Definition
    1. Hyponatremia with measured Serum Osmolality = 280-300
  3. Pathophysiology
    1. Water normally comprises 92-94% of serum
    2. Lipids or proteins decrease water fraction
  4. Causes
    1. PseudoHyponatremia (Isotonic)
      1. Hyperlipidemia (Serum Triglycerides >1500 mg/dl)
      2. Hyperproteinemia (Serum Protein > 10 g/dl)
    2. Isotonic (sodium-free) infusion
      1. Glucose
      2. Mannitol
      3. Glycine (used in some urologic procedures)
      4. Post-Transurethral prostatic resection syndrome
        1. Large volume intraoperative hypotonic irrigation
        2. Neurologic and cardiopulmonary signs
  5. Management
    1. Pseudohyponatremia
      1. PseudoHyponatremia does not need to be treated
      2. Evaluate and treat underlying cause (e.g. lipids)
    2. Isotonic Infusion
      1. Reflects true Hyponatremia and requires correction
  6. References
    1. Kone in Tisher (1993) Nephrology, p. 87-100
    2. Levinsky in Wilson (1991) Harrison's IM, p. 281-84
    3. Rose (1989) Acid-Base and Electrolytes, p. 601-38

Pseudohyponatremia (C0342582)

ConceptsFinding (T033)
EnglishHyponatraemia with normal or increased serum osmolality, Hyponatremia with normal or increased serum osmolality, Pseudohyponatraemia, Pseudohyponatremia
Spanishseudohiponatremia
Parent ConceptsHyponatremia (C0020625)
SourcesSCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)



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