![]() Other causes include decreased production of antidiuretic hormone (ADH also known as vasopressin) or decreased tubular sensitivity to the hormone (ie, diabetes insipidus), inappropriate forms of parenteral therapy with saline solutions, or high salt intake without corresponding intake of water. ![]() Hypernatremia is often associated with hypercalcemia and hypokalemia and is seen in liver disease, cardiac failure, pregnancy, burns, and osmotic diuresis. Hypernatremia (high sodium) is often attributable to excessive loss of sodium-poor body fluids. Symptoms of hyponatremia are a result of brain swelling and range from weakness to seizures, coma, and death. Hyponatremia also occurs in nephrotic syndrome, hypoproteinemia, primary and secondary adrenocortical insufficiency, and congestive heart failure. Renal loss may be caused by inappropriate choice, dose, or use of diuretics by primary or secondary deficiency of aldosterone and other mineralocorticoids or by severe polyuria. Hyponatremia (low sodium) is a predictable consequence of decreased intake of sodium, particularly that precipitated or complicated by unusual losses of sodium from the gastrointestinal tract (eg, vomiting and diarrhea), kidneys, or sweat glands. The amount of sodium in the body is a reflection of the balance between sodium intake and output. Sodium is responsible for almost one-half the osmolality of the plasma and, therefore, plays a central role in maintaining the normal distribution of water and the osmotic pressure in the extracellular fluid compartment. Sodium is the primary extracellular cation. ![]()
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