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Hyponatremia Prevention

By Dr Ananya Mandal, MD

Hyponatremia or a low blood sodium level can sometimes be corrected before it causes complications. The condition can also be prevented altogether by following certain preventive measures. Some examples of measures that can be taken to correct or prevent hyponatremia as well as points to consider when treating patients are isted below:

  • If intravenous sodium solution is prescribed to rise the blood sodium level, care must be taken not to administer too much of the solution too quickly. Rapid administration of sodium can increase the risk of a neurological condition developing called central pontine myelinolysis. The treatment is administered in a way that does not allow the blood sodium level to rise by more than 8 mmol/l every 24 hours.
  • The use of hypotonic fluids such as 5% glucose or sodium chloride 0.18% with glucose 4% and sodium chloride 0.45% should be routinely checked to avoid any risk of dilutional hyponatremia developing.
  • The patient’s blood levels of urea and electrolytes (sodium, potassium, magnesium, calcium and phosphates) should be routinely monitored. Their blood and urine osmolality should also be checked.
  • Fluid balance charts should be maintained regularly and accurately to detect hyponatremia and fluid overload.
  • Associated conditions such as adrenal gland insufficiency should be treated appropriately and adequately to avoid hyponatremia.
  • Healthcare staff should be aware of the hyponatremia risk associated with the use of certain medications such as diuretics.
  • Athletes should closely monitor their water intake. Athletes should drink enough fluid to replace the fluid lost during training but should also be careful not to drink so much fluid that they increase their risk for hyponatremia. For heavy training sessions, drinks containing electrolytes may be preferred to replenish the sodium and reduce the risk of hyponatremia.
  • Indicators that can help judge a patient’s water intake include their thirst level and the color of their urine. If they are not thirsty and their urine is pale yellow in color, they are well hydrated and the water intake has been adequate.

Reviewed by , BSc

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Last Updated: May 14, 2014

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