Hyponatremia in Pulmonary Disease
DOI:
https://doi.org/10.11594/jk-risk.05.3.7Keywords:
Hyponatremia, dysnatremia, electrolyte imbalance, lung diseaseAbstract
Hyponatremia is a decrease in blood sodium levels below 135 mEq/L. Sodium is essential for proper nerve and muscle function. Sodium disorders have traditionally been considered a marker of the severity of underlying disease, but increasing evidence suggests that these have detrimental effects on physiological function. Hyponatremia can occur due to various diseases, including lung diseases, which are lung cancer, chronic obstructive pulmonary disease (COPD), tuberculosis, pneumonia, cystic fibrosis (CF), and coronavirus disease 2019 (COVID-19). The most common causes associated with hyponatremia with it are SIDH, volume depletion (e.g., vomiting, diarrhea), anticancer therapy, diuretics, and decreased nutritional intake. Early detection and correction of hyponatremia can significantly improve patient outcomes, reduce morbidity and mortality, and enhance the quality of care.
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Lindner G, Schwarz C, Haidinger M, Ravioli S. Hyponatremia in the emergency department. American Journal of Emergency Medicine. 2022;60:1–8.
Paudel S, Dhanani M, Patel KH, Vakkalagadda NP, Sanker V, Damera AR, et al. Pulmonary tuberculosis in an adult presenting with severe hyponatremia: A case report and review of literature. Clin Case Rep. 2024;12(2):1–5.
Fibbi B, Marroncini G, Naldi L, Anceschi C, Errico A, Norello D, et al. Hyponatremia and Cancer: From Bedside to Benchside. Cancers (Basel). 2023;15(4):1–16.
Chalela R, González-García JG, Chillarón JJ, Valera-Hernández L, Montoya-Rangel C, Badenes D, et al. Impact of hyponatremia on mortality and morbidity in patients with COPD exacerbations. Respir Med. 2016;117:237–42.
Królicka AL, Kruczkowska A, Krajewska M, Kusztal MA. Hyponatremia in infectious diseases—a literature review. Int J Environ Res Public Health. 2020;17(15):1–16.
Otterness K, Singer AJ, Thode HC, Peacock WF. Hyponatremia and hypernatremia in the emergency department: severity and outcomes. Clin Exp Emerg Med. 2023;10(2):172–80.
Bayrak E, Çağlar K. HYPONATREMIA AS A FIRST SIGN OF SMALL CELL LUNG CANCER: A CASE REPORT. İstanbul Tıp Fakültesi Dergisi. 2020;83(4):451–3.
Lindner G, Herschmann S, Funk GC, Exadaktylos AK, Gygli R, Ravioli S. Sodium and potassium disorders in patients with COPD exacerbation presenting to the emergency department. BMC Emerg Med. 2022;22(1):1–6.
Sandfeld-Paulsen B, Aggerholm-Pedersen N, Winther-Larsen A. Hyponatremia as a prognostic factor in non-small cell lung cancer: A systematic review and meta-analysis. Transl Lung Cancer Res. 2021;10(2):651–61.
Wu R, Li C, Wang Z, Fan H, Song Y, Liu H. A narrative review of progress in diagnosis and treatment of small cell lung cancer patients with hyponatremia. Transl Lung Cancer Res. 2020 Dec;9(6):2469–78.
Seay NW, Lehrich RW, Greenberg A. Diagnosis and Management of Disorders of Body Tonicity—Hyponatremia and Hypernatremia: Core Curriculum 2020. American Journal of Kidney Diseases. 2020;75(2):272–86.
Kheetan M, Ogu I, Shapiro JI, Khitan ZJ. Acute and Chronic Hyponatremia. Front Med (Lausanne). 2021;8:1–9.
Sandfeld-Paulsen B, Aggerholm-Pedersen N, Winther-Larsen A. Hyponatremia in lung cancer: Incidence and prognostic value in a Danish population-based cohort study. Lung Cancer. 2021;153:42–8.
Saha SK, Ali MY, Islam M, Arif KM, Quader MR, Saha P. Pattern of Serum Electrolytes Imbalance among Patients with Acute Exacerbation of COPD Admitted in a Tertiary Level Hospital. Faridpur Med Coll. 2020;15(1):24–7.
Zukhruf M, Mumtaz A, Ashraf A, Safdar S, Aziz J, Mumtaz MA, et al. Frequency of Hyponatremia in Adult Patients with Pulmonary Tuberculosis. Journal of Health and Rehabilitation Research [Internet]. 2024;4:2791–156. Available from: https://jhrlmc.com/DOI:https://doi.org/10.61919/jhrr.v4i3.1584www.lmi.education/
WHO. World Tuberculosis Day 2024 [Internet]. WHO. 2024 [cited 2025 Jul 12]. Available from: https://www.who.int/indonesia/news/events/tb-day/tb-day-2024
Ewa AU, Ochang EA, Inaku KO, Adams EB, Anachuna KC, Imoke EJ, et al. Challenges of Diagnosing Hyponatremic Syndromes in Pulmonary and Extra Pulmonary Tuberculosis. Journal of Child Science. 2021;11(1):E14–7.
Dash M, Sen RK, Behera BP, Sahu SS. Prevalence of hyponatremia in pulmonary tuberculosis. International Journal of Advances in Medicine. 2019;7(1):63–6.
Nisar A, Lail A, Nisar D, Waheed SA, Saifullah N, Lail G. The Prevalence of Hyponatremia in Pulmonary Tuberculosis Patients, a Tertiary Care Hospital Experience from Pakistan. J Tuberc Res. 2019;07(4):259–66.
Mehmood Z, Saeed F, Siddiqui MA, Rehman FU, Zahoor F, Iqtidar A. Frequency of hyponatremia in community acquired pneumonia. The Professional Medical Journal. 2020;27(08):1546–9.
Müller M, Schefold JC, Guignard V, Exadaktylos AK, Pfortmueller CA. Hyponatraemia is independently associated with in-hospital mortality in patients with pneumonia. Eur J Intern Med. 2018;54:46–52.
Potasso L, Sailer CO, Blum CA, Cesana-Nigro N, Schuetz P, Mueller B, et al. Mild to moderate hyponatremia at discharge is associated with increased risk of recurrence in patients with community-acquired pneumonia: Hyponatremia and recurrence of pneumonia. Eur J Intern Med. 2020;75:44–9.
Akyil FT, Akyil M, Çoban Ağca M, Güngör A, Ozantürk E, Söğüt G, et al. Hyponatremia prolongs hospital stay and hypernatremia better predicts mortality than hyponatremia in hospitalized patients with community-acquired pneumonia. Tuberk Toraks. 2019;67(4):239–47.
Voets PJGM, Frölke SC, Vogtländer NPJ, Kaasjager KAH. COVID-19 and dysnatremia: A comparison between COVID-19 and non-COVID-19 respiratory illness. SAGE Open Med. 2021;9:1–5.
Piza PM de T, de Freitas VM, Aguiar-Brito I, Calsolari-Oliveira BM, Rangel ÉB. Impact of Hyponatremia on COVID-19-Related Outcomes: A Retrospective Analysis. Biomedicines. 2024;12(9):1–12.
Al Zaman K, Alhebsi AA, Almheiri A, Alhosani H, Alshehhi NT, Alwheibi ES. Syndrome of Inappropriate Antidiuretic Hormone (SIADH) in Chronic Respiratory Diseases: A Comprehensive Review. Cureus. 2025;17(1):e77407.
Declercq D, Van Braeckel E, Marchand S, Van daele S, Van Biervliet S. Sodium Status and Replacement in Children and Adults Living with Cystic Fibrosis: A Narrative Review. J Acad Nutr Diet. 2020;120(9):1517–29.
Sterns RH, Rondon-Berrios H, Adrogue HJ, Berl T, Burst V, Cohen DM, et al. Treatment Guidelines for Hyponatremia Stay the Course. Clinical Journal of the American Society of Nephrology. 2024;19(1):129–35.
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