Prevalence
Causes
Clinical
features
Investigations
Therapy
Prognosis
|  | | | Clinical
features |
Ask about
-
recent illness
-
diarrhoea
and vomiting
c
-
sweating
c
-
fluid intake
d
-
current medical problems
-
heart failure
c
-
renal disease
c
-
liver failure and ascites
c
-
diabetes mellitus
c
-
any psychiatric problems
c
-
current medication (particularly diuretics, NSAIDs, antibiotics) c
Why?
Hepatic failure and gastrointestinal losses increase the risk of
hyponatraemia
| Outcome
c
|
Risk Factor |
PEER |
OR
(95% CI) |
NNH
(95% CI) |
hyponatraemia
(Na < 135 mmol/l)
|
hepatic failure
not independent
|
4.6% |
2.91
(1.63 to
5.21) |
6
(3 to
17)
|
|
|
GI losses
not independent
|
11% |
1.99
(1.27 to
3.11) |
11
(6 to
39)
|
|
|
diabetes mellitus
not independent
|
18% |
1.62
(1.09 to
2.41) |
12
(6 to
78)
|
|
|
ascites
not independent
|
2.1% |
2.63
(1.12 to
6.17) |
31
(10 to
410)
|
|
|
sweating
not independent
|
1.6% |
5.39
(2.40 to
12.1) |
15
(7 to
46)
|
|
|
NSAIDs
not independent
|
7.7% |
1.86
(1.10 to
3.14) |
17
(8 to
140)
|
|
|
potassium-sparing diuretics
not independent
|
7.1% |
1.93
(1.13 to
3.30) |
17
(8 to
120)
|
|
|
trimethoprim/ sulfamethoxazole
not independent
|
1.9% |
3.51
(1.54 to
7.97) |
22
(9 to
100)
|
|
internal medicine