In the majority of cases, the prognosis of hyponatremia is benign. As soon as the sodium level is restored and the problem which caused it corrected, the hyponatremia usually does not recur and rarely there are sequelae related to it. This is the case when the low sodium is related to volume depletion or to hypertonic conditions such as hyperglycemia. However, in cases such as the syndrome of inappropriate secretion of anti diuretic hormone (SIADH), the sodium level will be persistently low and difficult to treat. Chronic therapies with medications such as demeclocycline or tolvaptan may be needed and the patient is at persistent risk of encephalopathy, falls, seizures and possibly death. In the case of cirrhosis or heart failure, hyponatremia is a marker of poor prognosis of the underlying condition and expresses how severe this underlying condition is¹.

If the correction of hyponatremia is too fast, osmotic demyelination syndrome (ODS) can occur. If this happens, the healthcare prognosis of the patient may be extremely poor due to the severe neurologic sequelae which may include quadriplegia and locked-in syndrome².

Marco A. Ramos MD, CCDS

References

1. Byung-Su Yoo, Jin Joo Park, Dong-Ju Choi, Seok-Min Kang, Juey-Jen Hwang, Shing-Jong Lin, Ming-Shien Wen, and Jian Zhang, “Prognostic value of hyponatremia in heart failure patients: an analysis of the Clinical Characteristics and Outcomes in the Relation with Serum Sodium Level in Asian Patients Hospitalized for Heart Failure (COAST) study,” Korean Journal of Internal Medicine 30, no. 4 (2015): 460-70. https://doi.org/10.3904/kjim.2015.30.4.460

2. Joshua King and Mitchell Rosner, “Osmotic Demyelination Syndrome,” American Journal of Medical Sciences 339, no. 6 (2010): 561-7. https://doi.org/10.1097/MAJ.0b013e3181d3cd78

Any information or statement present in this post does not replace your health care provider’s advice or treatment. This blog does not provide medical advice, prescribe medications or therapies, or diagnose conditions, it only expresses an opinion. If you have a health-related question or condition, confer with your healthcare provider.

- In order to quote from this article please use the following:

Marco A. Ramos, “Hyponatremia for Everyone. #8. Prognosis of Hyponatremia,” SMO Blog (blog), September 12, 2018, https://steemit.com/health/@secondmedicalop/hyponatremia-for-everyone-8-prognosis-of-hyponatremia

Read the other sections of this series:

Introduction
What Causes Hyponatremia? A
What Causes Hyponatremia? B
What Causes Hyponatremia? C
What Causes Hyponatremia? D
How Common is Hyponatremia?
What Happens when Someone has Hyponatremia?
Signs and Symptoms of Hyponatremia
Diagnosis and Tests used in Hyponatremia
Treatment of Hyponatremia

Picture purchased and downloaded from istockphoto.com under a standard license Author: Nerthuz