Disorders of sodium balance

doi:10.1136/bmj.332.7543.702

BMJ 2006;332:702-705 (25 March), doi:10.1136/bmj.332.7543.702

Clinical review

Disorders of sodium balance

Rebecca M Reynolds, senior lecturer in endocrinology and diabetes¹, Paul L Padfield, consultant physician², Jonathan R Seckl, Moncrieff-Arnott professor of molecular medicine¹

¹ Endocrinology Unit, Centre for Cardiovascular Sciences, University of Edinburgh, Queen's Medical Research Institute, Edinburgh EH16 4TJ, ² Metabolic Unit, Western General Hospital, Edinburgh EH4 2XU

Correspondence to: J R Seckl j.seckl@ed.ac.uk

The first 150 words of the full text of this article appear below.

Introduction

Disorders of plasma sodium are the most common electrolyte disturbancesin clinical medicine, yet they remain poorly understood. Severehyponatraemia and hypernatraemia are associated with considerablemorbidity and mortality,^1-3 however, and even mild hyponatraemiais associated with worse outcomes when it complicates conditionssuch as heart failure,⁴ although which is cause and which effectis often uncertain. Distinguishing the cause(s) of hyponatraemiamay be challenging in clinical practice, and controversies surroundingits management remain. Here, we describe the common causes ofdisorders of plasma sodium, offer guides to their investigationand management, and highlight areas of recent advance and ofuncertainty.

Sources and selection criteria

We incorporated the latest consensus from systematic reviewsand publications identified by a literature search through Medlineand Web of Science with the search strategy terms "hyponatraemia,""hypernatraemia," and "sodium." We found fewer than a dozenrandomised controlled trials of treatment of any description.Despite their frequency, plasma sodium . . . [Full text of this article]

Control of sodium balance

Hyponatraemia

Hypernatraemia

Final thoughts

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