The patient is considered to have hyponatraemia when sodium is below 125 mol/l. The condition is considered severe when sodium is below 115 mEq/l.There are several obscure and complicated mechanisms to hyponatremia. The most common mechanism of hyponatraemia is the retention of fluid in the body, when the patient is normo- to hypervolaemic. Neurological symptoms usually appear when serum sodium falls below 115 mEq/l. The severity of symptoms depends on how rapidly the condition develops. Initial laboratory tests: Serum sodium, potassium, creatinine and blood glucose. Later tests: Serum and urine osmolarity, urine sodium. Clearly elevated triglyceride or paraproteinaemia causes pseudohyponatraemia where serum osmolarity is normal.


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