Hyponatriämie – Diagnose und Therapie

Da die Hyponatriämie potenziell lebensbedrohlich sein kann, ist ein effizientes Management unerlässlich. Es umfasst das Identifizieren der auslösenden Ursache und die anschließende gezielte Therapie unter Vermeidung therapieassoziierter Nebenwirkungen (z. B. pontine Myelinolyse). Dieser Beitrag erklärt die Pathophysiologie und Differenzialdiagnosen der Hyponatriämie und erläutert praxisorientiert die Diagnostik und Therapie.

Abstract

Hyponatremia is a common condition affecting hospitalized and ambulatory patients as well. The clinical spectrum of hyponatremia can range from asymptomatic laboratory findings to severely symptomatic conditions such as acute epileptic seizures. Etiologies of hyponatremia include excessive intake of solute-free fluids, side-effects of medication, diseases associated with hypervolemic states such as congestive heart failure, and the syndrome of inappropriate antidiuretic hormone secretion (SIADH).

As hyponatremia can be a potentially life-threatening condition, it requires an efficient management with the goal of identifying the etiology and to subsequently provide adequate treatment, while avoiding treatment-related adverse effects such as overcorrection and pontine myelinolysis. This article summarizes the pathophysiology and differential diagnosis, as well as useful diagnostic tests and therapy of hyponatremia in a practice-oriented manner.

Schlüsselwörter

Hyponatriämie - Serumnatrium - SIADH - Hirnödem - pontine Myelinolyse

Key words

hyponatremia - serum sodium - SIADH - brain edema - pontine myelinolysis

Publication History

Article published online:
20 October 2020

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