Causes of hyponatremia and their usual corresponding urine studies and urine output
Volume status | Etiology | Urine osmolality | Urine sodium | ADH-dependent | Urine output |
---|---|---|---|---|---|
Hypovolemic | Volume loss (nonrenal) | > 100 mOsm/Kg | < 30 mmol/L | Yes | Decreased |
Cerebral salt wasting | > 100 mOsm/Kg | > 30 mmol/L | Yes | Increased | |
Diuretics | > 100 mOsm/Kg | > 30 mmol/L | Yes | Increased | |
Euvolemic | Syndrome of inappropriate ADH | > 100 mOsm/Kg | > 30 mmol/L | Yes | Decreased |
Low-solute state | < 100 mOsm/Kga | < 30 mmol/L | No | Variable | |
Primary polydipsia | < 100 mOsm/Kg | Variable | No | Increased | |
Reset osmostat | Variable | Variable | No | Variable | |
Hypervolemic | Cirrhosis | > 100 mOsm/Kg | < 30 mmol/L | Yes | Decreased |
Heart failure | > 100 mOsm/Kg | < 30 mmol/L | Yes | Decreased | |
Kidney failure | > 100 mOsm/Kg | > 30 mmol/L | No | Decreased |
↵a The osmolality in a low-solute state can be higher in a concomitant hypovolemic state.
ADH = antidiuretic hormone