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Imeboreshwa:
ULY CLINIC
ULY CLINIC
20 Oktoba 2026, 08:11:49
Hyponatraemia
Severity | Sodium (mmol/L) | Features |
Mild | 130–134 | May be asymptomatic; headache, nausea, fatigue |
Moderate | 125–129 | Headache, vomiting, gait disturbance, confusion |
Severe | Below 125 | Seizures, reduced consciousness, coma, respiratory arrest |
Acute | Develops in under 48 hours | Water intoxication, post-operative fluids, drugs |
Management by type
Type | Causes | Management |
Hypovolaemic | Vomiting, diarrhoea, diuretics, burns, adrenal insufficiency | Treat the cause; D: 0.9% sodium chloride IV cautiously; monitor sodium closely |
Euvolaemic | SIADH, hypothyroidism, glucocorticoid deficiency, excess water intake | Treat the cause; fluid restriction; specialist if severe or persistent |
Hypervolaemic | Heart failure, cirrhosis, nephrotic syndrome, kidney failure | With overload: A: furosemide (PO) 40 mg twice daily, increased by response |
Severe symptomatic acute | Water intoxication, severe SIADH, post-operative | D: 3% sodium chloride IV under specialist supervision with frequent sodium checks |
Correct chronic hyponatraemia by no more than 8 mmol/L in 24 hours – faster correction can cause irreversible osmotic demyelination.
Monitor sodium frequently, fluid balance, neurological status, kidney function and potassium.
Imeandikwa:
20 Oktoba 2026, 08:09:44
Rejea za mada hii:
Ministry of Health, United Republic of Tanzania. Standard Treatment Guidelines and National Essential Medicines List for Tanzania Mainland (STG & NEMLIT). 7th ed. Dodoma: Ministry of Health; 2026. Chapter 21, Kidney and Urological Disorders: section 21.1.10 Hyponatraemia (Tables 21.9–21.10), pp. 535–536.