Hyponatremia laboratory findings

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Saeedeh Kowsarnia M.D.[2]

Overview

An elevated/reduced concentration of serum/blood/urinary/CSF/other [lab test] is diagnostic of [disease name].

OR

Laboratory findings consistent with the diagnosis of [disease name] include [abnormal test 1], [abnormal test 2], and [abnormal test 3].

OR

[Test] is usually normal among patients with [disease name].

OR

Some patients with [disease name] may have elevated/reduced concentration of [test], which is usually suggestive of [progression/complication].

OR

There are no diagnostic laboratory findings associated with [disease name].

Laboratory Findings

Biochemical evaluation for finding the etiologies of hyponatremia :

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2

For approach to differential diagnosis click here.

For clinical approach to diagnosis click here.


Characteristics Hypervolemic

Hyponatremia

Euvolemic

Hyponatremia

Hypovolemic

Hyponatremia

Total body water ↑↑
Serum sodium level ↓↓
Plasma Osmolality, mOsm/kg < 280 <280 ≥ 280
Urine Osmolality, mOsm/L > 100 > 100 > 500
Urine sodium level, mEq/L < 20 or >20 > 20 < 10 or > 20
Differentiation of causes > 20 mEq/L urinary sodium:
  • Acute or chronic renal failure
  • Fluid overload
  • Psychogenic polydipsia

< 20 mEq/L urinary sodium:

  • Heart failure
  • Cirrhosis
  • Nephritic syndrome
  • SIADH/SIAD
  • Adrenal insufficiency
  • Hypothyroidism
  • Drugs
< 10 mEq/L urinary sodium:
  • Diuretics
  • Extrarenal loss such as diarrhea, vomiting
  • Severe hyperglycemia
  • Third spacing of fluids

> 20 mEq/L urinary sodium:

  • Adrenal insufficiency
  • Renal bicarbonate loss(renal tubal acidosis,

metabolic alkalosis)

  • Renal sodium loss (cerebral salt wasting, salt-wasting nephropathy)
  • Diuretics
  • There are no diagnostic laboratory findings associated with [disease name].

OR

  • An elevated/reduced concentration of serum/blood/urinary/CSF/other [lab test] is diagnostic of [disease name].
  • [Test] is usually normal among patients with [disease name].
  • Laboratory findings consistent with the diagnosis of [disease name] include:
    • [Abnormal test 1]
    • [Abnormal test 2]
    • [Abnormal test 3]
  • Some patients with [disease name] may have elevated/reduced concentration of [test], which is usually suggestive of [progression/complication].

References

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