Poster Presentation ESA-SRB 2023 in conjunction with ENSA

An audit on clinical characteristics and hospital course of patients admitted with hyponatremia. (#243)

Divij Sharma 1 , Sukesh Chandran 1
  1. St John of God Hospital Perth, Midland, WESTERN AUSTRALIA, Australia

64d8bb533e789-TABLE.pngAims

  1. To investigate the frequency, clinical, biochemical characteristics, underlying diagnosis and clinical outcomes, and patient profiles of 30 hyponatremic patients.
  2. To classify which treatment regime and correction rate was followed as per European Society of Endocrinology Guidelines.

Methods

 We classified patients according to the clinical severity of Na as mild, moderate and severe. They were also classified into acute vs. chronic as per the time of development (48 hours is cut off), symptomatic vs. asymptomatic, and hypovolemic vs. euvolemic vs. hypervolemic. This classification was done to evaluate directions for diagnosis and treatment. In addition, the records of these patients were reviewed for relevant demographic, clinical, and laboratory data. The underlying diagnoses and complications after treatment were also sought.

Result

 The Image represents data as per clinical, demographic characteristics and treatment administered in 30 hyponatremic patients.

Interestingly, rare conditions like autoimmune encephalitis and glioblastoma were the underlying cause of 4 euvolemic hyponatremic patients.

On the treatment front, 12 patients had more than one cause behind the hyponatremia; hence more than one treatment modality was administered in these patients.  European guidelines recommend a rate of around 10 mmol/L per day. However, we kept the range of 6-8mmol/L as our reference due to the risk of Osmotic Demyelination Syndrome in high-risk patients. This table illustrates that the correction rate did not exceed recommended limits.

Conclusion

Following European guidelines, no treatment modality stood as the absolute gold standard or benefit in our audit; hence we saw that more than one regime was meticulously used in most patients to reach the Na target. More than 50% of patients had hyponatremia detected incidentally on routine biochemical tests, consistent with the literature. This audit is directed for doctors across all sub-specialties to know recent treatment guidelines for diagnosing and managing hyponatremia patients.