II. Pathophysiology

  1. Edematous state reduces effective circulating volume
  2. Decreased flow to nephron diluting segment
  3. Stimulates ADH release

III. Causes

  1. Edematous States
    1. Urine Sodium < 10-15 meq/L (if no Diuretic use)
    2. Urine Osmolality >350 mOsm/kg water
    3. Conditions
      1. Cirrhosis
      2. Congestive Heart Failure
      3. Nephrotic Syndrome
  2. Advanced Renal Insufficiency
    1. Urine Sodium > 20 meq/L

VI. Management

  1. See Hyponatremia Management
  2. Salt and water restriction
  3. Optimize Cardiac Output
  4. Consider Dialysis for Renal Insufficiency
  5. Consider Diuretics

VII. 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
  4. Braun (2015) Am Fam Physician 91(5): 299-307 [PubMed]

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Ontology: Hyponatremia with excess extracellular fluid volume (C0268816)

Concepts Disease or Syndrome (T047)
SnomedCT 42669007
English Hyponatremia with excess extracellular fluid volume, Hyponatraemia with excess extracellular fluid volume, Hyponatremia with excess extracellular fluid volume (disorder)
Spanish hiponatremia con aumento de volumen del líquido extracelular (trastorno), hiponatremia con aumento de volumen del líquido extracelular