Very low sodium alone can cause unconsciousness. With an infection, this may be profound.
Low sodium usually responds to intravenous sodium infusion.
The following condition can cause sodium deficiency;
1) High blood sugar (diabetes)
2) Hyperlipidemia (high cholesterol and triglycerides)
3) Paraproteinemia; increased proteins in the body
4) Medications like a diuretic
5) Kidney diseases affecting the renin-angiotensin system
6) Antidiuretic hormone (ADH) secretion
7) salt-wasting nephropathy (kidney disease)
8) Liver cirrhosis,
9) Congestive heart failure,
10) Nephrotic syndrome,
11) Nonsteroidal anti-inflammatory drug (NSAID) use may increase the risk of development of hyponatremia
Investigations to assess the causes for low sodium are;
1) Urine osmolality
2) Serum osmolality
3) Urinary sodium concentration
4) Serum albumin,
5) Serum triglycerides,
6) Serum protein electrophoresis
7) Thyroid-stimulating hormone (TSH)
8) Serum cortisol levels
9) Serum uric acid levels
The treatment is dependent on the severity of deficiency of sodium, mode of onset, and cause. If it is severe and sudden, intravenous saline drips are required, with periodic monitoring of the blood levels of the sodium and management of the cause (like kidney disease will need dialysis) takes care of the deficiency.
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