Hyponatremia in dialysis patients?

summary

Hyponatremia is a disease in which serum sodium is less than 135 mmol / L. it only reflects the decrease of sodium concentration in plasma and does not necessarily mean the loss of total sodium in the body. The total sodium can be normal or even slightly increased. Hyponatremia can be divided into hypovolemic hyponatremia, hyponatremia with normal blood volume and hyponatremia with high blood volume. It is very common in clinic, especially in the elderly. Hyponatremia in dialysis patients? Let's talk about it

Hyponatremia in dialysis patients?

The severity depends on the rate of decrease in blood [Na] and sodium. When blood [Na] is above 125 mmol / L, it rarely causes symptoms[ When the concentration of Na was between 125 and 130 mmol / L, there were only gastrointestinal symptoms. At this time, the main symptoms were weakness, nausea and vomiting, headache and sleepiness, muscle spasm, neuropsychiatric symptoms and reversible ataxia.

In the early stage of hyponatremia, brain cells have adaptive regulation to the imbalance of intracellular and extracellular osmotic pressure. Within 1-3 hours, the extracellular fluid in brain moved into cerebrospinal fluid and then returned to systemic circulation; If hyponatremia persists, the adaptive regulation of brain cells is to discard the organic osmotic solutes including phosphate, creatine, inositol and amino acids (such as alanine and aminoethanesulfonic acid) to reduce cell edema. If the adaptive regulation of brain cells fails, brain cell edema will follow. The clinical manifestations included convulsion, numbness, coma and intracranial pressure elevation,

Tentorium hernia may occur in severe cases. If hyponatremia occurs within 48 hours, it is very dangerous and can lead to permanent neurological damage. The patients with chronic hyponatremia have the risk of osmotic demyelination, especially when hyponatremia is corrected excessively or too quickly.

matters needing attention

(1) Avoid raw avoid cold, greasy food (2) for early diluted hyponatremia to strictly limit the amount of drinking water, give common food or high sodium food（ 3) For hyponatremia with heart disease and hypertension, people should not eat too much salt（ 4) Pay attention to eat more salty food, in order to supplement the loss of salt in the body, to achieve the body needed balance.